In this study, IVIG did not significantly reduce the rate of infection, the duration of air flow or the time to clinical recoveryKacet 1991The authors do not provide plenty of information regarding definitions of outcomes for inclusion with this systematic reviewKinney 1991This is a double\blind RCT designed to determine whether IVIG administration modifies the incidence of infection in high\risk neonates. verify meanings of terms. The two review authors individually abstracted info on each study, and one review author (AO) checked for any discrepancies and pooled the results. Data abstraction included whether the study involved prophylaxis or treatment, the number of participants enrolled, the number of participants enrolled but later on excluded, the time period and geographical location of the study, baseline characteristics of participants, inclusion/exclusion criteria, the preparation and dosing routine of IVIG and placebo and length of follow\up. Information on results and on the numbers of affected babies was abstracted. The total number of babies with sepsis (medical signs and symptoms plus positive blood culture (bacteria or fungi)) and any serious infection (clinical signs and symptoms in conjunction with positive ethnicities (bacteria or fungi) from normally sterile body fluids) was abstracted, as was info on NEC, death from all Clafen (Cyclophosphamide) causes and death from illness. Info on length of hospital stay and on incidence of BPD and IVH was collected. Information on probable infection was not collected, as the meanings used by different investigators were too variable. Assessment of risk of bias in included studies Clafen (Cyclophosphamide) Assessment of the quality of included studies (excluding abstracts) was performed individually by JBL and AO, using criteria developed by the Cochrane Neonatal Review Group. These criteria included blinding of randomisation, blinding of the treatment, complete adhere to\up and blinding of end result measurement. For each criterion, three options were recognized: yes, can’t tell and no. The task Rabbit Polyclonal to MRPL21 was not done with the assessors blinded to author, institution, journal of publication or results, as both assessors were familiar with most of the studies and with the typographical layout of the journals and would have knowledge of these even when blinded. In addition, the results sections of content articles often include methodological info. After self-employed evaluation was performed, the two assessors discussed the results of each study, and any discrepancies were resolved.? For the upgrade in 2009 2009, the following issues were evaluated and entered into the risk of bias table: Sequence generation: Was the allocation sequence adequately generated?;? Allocation concealment: Was allocation properly concealed?;? Blinding of participants, personnel and end result assessors: Was knowledge of the allocated treatment adequately prevented during the study? At study entry? At the time of end result assessment?;? Clafen (Cyclophosphamide) Incomplete end result data: Were incomplete outcome data properly addressed?; Selective end result reporting: Are reports of the study free of suggestion of selective end result reporting?; and? Additional sources of bias: Was the study apparently free of other problems that could put it at high risk of bias? Actions of treatment effect The statistical package (RevMan 5.2) provided by the Cochrane Collaboration was used. Standard relative risk (RR) and standard risk difference (RD) with 95% confidence intervals (CIs) using the fixed\effect model are reported. If a statistically significant reduction in RD was mentioned, the number needed to treat to benefit (NNTB) or harm (NNTH) was determined. Assessment of heterogeneity Statistically significant between\study heterogeneity was reported when recognized, and the test for inconsistency (I2 statistic) was applied when statistically significant heterogeneity was mentioned (Higgins 2003). For this update, the following cut\offs were used: <25%: no heterogeneity; 25% to 49%: low heterogeneity; 50% to 74%: moderate heterogeneity; and > 75%: high heterogeneity. Data synthesis Meta\analysis was performed using Review Manager software (RevMan 5.2) while supplied by The Cochrane Collaboration. For estimations of standard RR and RD, we used Clafen (Cyclophosphamide) the Mantel\Haenszel method. For measured quantities, we used the inverse variance method. All meta\analyses were carried out using the fixed\effect model. Subgroup analysis and investigation of heterogeneity Long term updates will consider post hoc subgroup analyses to explore any heterogeneity noted in the primary analysis. Results Description of studies Included Studies Details of the included studies are provided in the Table of Included Studies. Nineteen studies, including approximately 5000 preterm and/or LBW babies, met inclusion criteria. These studies were performed in many countries (US, Italy, UK, Saudi Arabia, France, Thailand, Belgium, Turkey, Sweden.