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Sustained lung inflation in late preterm infants: a randomized controlled trial
D Mercadante1, M Colnaghi1, V Polimeni1
1NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Insights
Sustained lung inflation (SLI) at birth did not reduce the need for respiratory support in late preterm infants. This intervention did not significantly alter neonatal intensive care unit admissions or length of stay.
Area of Science:
- Neonatology
- Pediatric Respiratory Medicine
- Critical Care
Background:
- Late preterm infants (34-36 weeks gestation) are at increased risk for respiratory complications.
- Sustained lung inflation (SLI) is a potential intervention to improve respiratory outcomes at birth.
Purpose of the Study:
- To evaluate the efficacy of SLI at birth in reducing the need for respiratory support in late preterm infants.
Main Methods:
- A controlled trial randomized 185 infants to receive SLI or standard care.
- Primary outcome: need for any respiratory support. Secondary outcomes: NICU admission for respiratory distress, length of stay.
Main Results:
- No significant difference in the need for respiratory support between SLI and control groups (10.6% vs 8.7%).
- Neonatal intensive care unit admission rates and length of stay were comparable between groups.
Conclusions:
- Sustained lung inflation at birth does not appear to reduce the requirement for respiratory support in late preterm infants.
- Further research may be needed to explore alternative or refined respiratory support strategies for this population.
Objective:
To assess the need for respiratory support in late preterm infants treated with sustained lung inflation (SLI) at birth.
Study Design:
In this controlled trial, we randomly assigned infants born at 34(+0) to 36(+6) weeks of gestation to receive SLI (25 cmH2O for 15 s) at birth, followed by continuous positive airway pressure (CPAP) or assistance according to the recommendations of the American Academy of Pediatrics. The primary outcome was the need for any type of respiratory support. The secondary outcomes included neonatal intensive care unit (NICU) admission for respiratory distress and length of stay. The risk ratios (RRs) and 95% confidence intervals (CIs) of the outcomes were calculated for the SLI group in reference to the control group.
Results:
A total of 185 infants were enrolled: 93 in the SLI group and 92 in the control group. No difference was found in the need for any type of respiratory support between the infants treated with SLI and the control group (10.6 vs 8.7%, RR 1.24, 95% CI 0.51 to 2.99). The NICU admission for respiratory distress and the length of stay did not differ between the groups.
Conclusion:
Providing SLI at birth in late preterm infants does not affect their need for respiratory support.
