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Related Experiment Video

Updated: Apr 17, 2026

The Perinatal Asphyxiated Lamb Model: A Model for Newborn Resuscitation
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Sustained inflation during neonatal resuscitation.

Martin Keszler1

  • 1Department of Pediatrics, Alpert Medical School of Brown University, Women and Infants Hospital, Providence, Rhode Island, USA.

Current Opinion in Pediatrics
|February 18, 2015
PubMed
Summary

Sustained inflation in preterm infants shows a modest benefit in reducing mechanical ventilation needs. However, more research is needed due to inconsistent results and potential risks like airleak and hemorrhage.

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Area of Science:

  • Neonatal Resuscitation
  • Respiratory Physiology
  • Pediatric Critical Care

Background:

  • Sustained inflation (SI) is increasingly used in preterm infants to clear lung fluid and establish functional residual capacity.
  • While physiologically plausible and supported by preclinical data, clinical evidence for SI effectiveness remains inconsistent.
  • Recent multicenter trials offer new insights into SI's benefits and risks.

Purpose of the Study:

  • To evaluate the effectiveness of delivery room sustained inflation in preterm neonates.
  • To synthesize current evidence on the benefits and risks of sustained inflation.
  • To determine if widespread clinical application is warranted.

Main Methods:

  • Review of recent multicenter randomized trials and animal studies.

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  • Analysis of data on mechanical ventilation rates, airleak, and intraventricular hemorrhage.
  • Assessment of the role of spontaneous respiratory effort in SI effectiveness.

    • Main Results:

    • A multicenter randomized trial suggests a modest benefit of SI in reducing mechanical ventilation in extremely-low-birth-weight infants.
    • The observed benefits may be less pronounced than previously suggested by retrospective studies.
    • Concerns exist regarding increased airleak and intraventricular hemorrhage rates with SI.
    • SI may be less effective without spontaneous respiratory effort.

    Conclusions:

    • Delivery room sustained inflation is a promising intervention for preterm infants.
    • Widespread clinical adoption should be deferred pending results from ongoing trials.
    • Further research is crucial to definitively establish the role and safety of SI.