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Related Experiment Video

Updated: Mar 25, 2026

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
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Sustained inflation: Prophylactic or rescue maneuver?

G Lista1, F Cavigioli1, F Castoldi1

  • 1NICU -"V. Buzzi" Children's Hospital, ICP, Milan, Italy.

Seminars in Fetal & Neonatal Medicine
|March 1, 2016
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Summary

Sustained inflation may improve respiratory support for preterm infants by clearing lung fluid and enhancing the success of nasal continuous positive airway pressure (nCPAP). Further research is needed to confirm its role in delivery room management.

Keywords:
Preterm infantsProphylaxisRescueSustained inflation

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Area of Science:

  • Neonatal medicine
  • Pediatric respiratory care
  • Perinatal respiratory support

Background:

  • Nasal continuous positive airway pressure (nCPAP) is a viable alternative to mechanical ventilation for preterm infants with respiratory failure, reducing bronchopulmonary dysplasia and mortality.
  • However, nCPAP initiation at birth has a high failure rate, necessitating alternative or adjunctive strategies.
  • Effective respiratory transition at birth is crucial for preterm infants, involving lung fluid clearance and establishing functional residual capacity.

Purpose of the Study:

  • To evaluate the potential of sustained inflation as an adjunct to improve respiratory transition in preterm infants.
  • To assess whether sustained inflation can enhance the success rate of nCPAP.
  • To determine the impact of sustained inflation on the need for mechanical ventilation and clinical outcomes in the early neonatal period.

Main Methods:

  • The study investigates the application of sustained inflation, focusing on its physiological effects like lung fluid clearance and functional residual capacity establishment.
  • The efficacy of sustained inflation was assessed in relation to the infant's respiratory effort, specifically the presence of an open glottis and active breathing.
  • The research considers the impact of sustained inflation on the requirement for mechanical ventilation within the first 72 hours of life.

Main Results:

  • Sustained inflation demonstrated a reduction in the need for mechanical ventilation in the initial 72 hours of life for preterm infants.
  • The incidence of bronchopulmonary dysplasia and death remained unchanged with the use of sustained inflation.
  • The effectiveness of sustained inflation appears to be contingent upon the infant's active breathing and an open glottis.

Conclusions:

  • Sustained inflation is a promising intervention for facilitating respiratory transition in preterm infants at birth.
  • It may enhance the success of nasal continuous positive airway pressure (nCPAP) by optimizing lung aeration.
  • Further clinical trials are required to establish definitive recommendations for the use of sustained inflation in the delivery room management of at-risk preterm infants.