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[Application of sustained lung inflation in preterm infants with a gestational age of <34 weeks: a Meta analysis]
Min-Xu Li1, Hao-Hui Deng, Jin-Zhen Su
1Department of Neonatology, Dongguan Maternal and Child Health Hospital, Dongguan, Guangdong 523000, China. dgyy666@sina.com.
Insights
Sustained lung inflation (SLI) reduces mechanical ventilation needs in preterm infants (<34 weeks gestation). This intervention does not increase risks for mortality or common complications, offering a safer approach for vulnerable newborns.
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Care
- Clinical Trials Research
Background:
- Preterm infants (<34 weeks gestation) often require respiratory support.
- Mechanical ventilation, while life-saving, carries risks of complications.
- Alternative or adjunctive strategies to noninvasive ventilation are crucial.
Purpose of the Study:
- To systematically review the efficacy of sustained lung inflation (SLI) in preterm infants.
- To compare SLI with noninvasive positive pressure ventilation (NIPPV) alone.
- To assess the impact of SLI on mechanical ventilation rates and infant outcomes.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched multiple databases including PubMed, Embase, and Cochrane Library.
- Included 9 RCTs involving 1,432 preterm infants (23-33.7 weeks gestation).
Main Results:
- Sustained lung inflation significantly reduced the need for mechanical ventilation within 72 hours (51.9% vs 56.9%).
- No significant differences were observed in mortality rates.
- Incidence of bronchopulmonary dysplasia, pneumothorax, and severe intracranial hemorrhage remained comparable.
Conclusions:
- Sustained lung inflation is effective in reducing mechanical ventilation use in preterm infants.
- SLI does not elevate the risk of major neonatal complications.
- SLI presents a potentially beneficial strategy for respiratory support in this population.
Objective:
To systematically review the effect of sustained lung inflation (SLI) in preterm infants with a gestational age of <34 weeks.
Methods:
PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, China Biology Medicine disc, Chinese Journal Full-text Database, and Weipu Database were searched for randomized controlled trials (RCTs) on the application of SLI versus noninvasive positive pressure ventilation alone in preterm infants. Revman 5.3 was used to perform a Meta analysis for the RCTs which met the inclusion criteria.
Results:
A total of 9 RCTs were included, with 1 432 preterm infants in total (with a gestational age of 23-33.7 weeks). The Meta analysis showed that compared with the control group, the SLI group had a significantly lower proportion of the infants who needed mechanical ventilation within 72 hours (51.9% vs 56.9%, RR=0.91, P=0.04, 95%CI: 0.83-0.99). There were no significant differences between the two groups in the mortality rate, rate of use of pulmonary surfactant, and incidence rates of related complications (bronchopulmonary dysplasia, pneumothorax, and grade III-IV intracranial hemorrhage) (P>0.05).
Conclusions:
SLI can reduce the use of mechanical ventilation in preterm infants with a gestational age of <34 weeks and does not increase the risk of other complications.
