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Does sustained lung inflation at resuscitation reduce lung injury in the preterm infant?

A E Harling1, M W Beresford, G S Vince

  • 1NICU, Liverpool Women's Hospital, Liverpool L8 7SS, UK. Elizabeth.Harling@lwh-tr.nwest.nhs.uk

Archives of Disease in Childhood. Fetal and Neonatal Edition
|May 3, 2005
PubMed

Insights

Sustained lung inflation during resuscitation did not reduce lung injury in preterm infants. This method did not significantly alter inflammatory markers or improve survival without bronchopulmonary dysplasia (BPD).

Area of Science:

  • Neonatal Resuscitation
  • Pulmonary Medicine
  • Pediatric Critical Care

Background:

  • Bronchopulmonary dysplasia (BPD) is a frequent complication in preterm infants, often linked to initial lung injury from ventilation strategies.
  • Sustained lung inflation (SLI) at birth may aid lung fluid clearance and functional residual capacity (FRC) establishment.
  • Previous studies suggest SLI could enable gentler ventilation, reducing inflammation and BPD.

Purpose of the Study:

  • To evaluate if SLI at initial resuscitation reduces lung fluid, establishes FRC, and improves alveolar distribution in preterm neonates.
  • To determine if SLI leads to less aggressive ventilation, reduced pulmonary inflammation, and decreased BPD incidence.
  • To assess the impact of SLI on inflammatory markers and clinical outcomes in very preterm infants.

Main Methods:

  • A study involving 52 preterm infants (<31 weeks gestation) compared SLI (5 seconds) versus conventional lung inflation (2 seconds) at birth.
  • Pulmonary inflammation was assessed by quantifying interleukins (IL-6, IL-10, IL-1β) and tumor necrosis factor-alpha (TNF-α) in bronchoalveolar lavage fluid.
  • Enzyme-linked immunosorbent assay (ELISA) was used for cytokine quantification.

Main Results:

  • No significant differences were observed in the measured cytokine levels between the SLI and conventional groups.
  • Mortality rates were 3/26 in the conventional group and 6/26 in the SLI group.
  • Survival without BPD occurred in 13/26 infants in the conventional group and 14/26 in the SLI group.

Conclusions:

  • Sustained lung inflation at resuscitation did not significantly reduce lung injury, as indicated by inflammatory markers.
  • The study did not find evidence that SLI improves inflammatory status or reduces BPD in this cohort.
  • SLI did not demonstrate a benefit in reducing lung injury markers in preterm infants.
Abstract

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