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Sustained lung inflation at birth via short binasal prong in very low birth weight preterm infants: A retrospective

Mehmet Buyuktiryaki1, Hayriye G Kanmaz1, Nilufer Okur1

  • 1Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.

Pediatric Pulmonology
|July 13, 2018
PubMed

Insights

Sustained lung inflation (SLI) at birth for preterm infants significantly reduces the need for mechanical ventilation (MV). This intervention also lowered the incidence of bronchopulmonary dysplasia (BPD), indicating improved respiratory outcomes.

Area of Science:

  • Neonatal Medicine
  • Respiratory Physiology
  • Pediatric Critical Care

Background:

  • Sustained lung inflation (SLI) at birth is hypothesized to reduce mechanical ventilation (MV) needs and improve respiratory outcomes in preterm infants.
  • Preterm infants are at high risk for respiratory distress syndrome (RDS), often requiring respiratory support.

Purpose of the Study:

  • To compare the need for MV in preterm infants at high risk for RDS.
  • To evaluate the efficacy of prophylactic SLI via short binasal prongs at birth combined with early nasal continuous positive airway pressure (nCPAP) versus nCPAP alone.

Main Methods:

  • Retrospective assessment of medical records for infants born between 26 and 29 weeks gestation (2015-2017).
  • Study group received SLI (25 cmH2O for 15s) via binasal prongs post-delivery.
  • Control group received nCPAP (6 cmH2O PEEP) alone; rescue surfactant was administered for established RDS.

Main Results:

  • Fewer infants in the SLI group required MV within 72 hours (25.7% vs. 56.9%, P < 0.001).
  • SLI was an independent factor for reduced MV need.
  • Bronchopulmonary dysplasia (BPD) incidence was significantly lower in the SLI group (31.9% vs. 48%, P = 0.01).

Conclusions:

  • Prophylactic SLI at birth for preterm infants with impending RDS reduces the need for MV.
  • SLI demonstrated no adverse effects in this cohort.
  • SLI may be a beneficial intervention for improving respiratory outcomes in high-risk preterm infants.
Abstract

Keywords:
delivery roommechanical ventilationpreterm infantrespiratory distress syndromesustained lung inflation

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