Lung recruitment with HFOV versus VTV/AC in preterm infants with RDS

To compare the effect of lung recruitment using high frequency ventilation versus volume targeted ventilation on duration of intubation as well as its effect on lung inflammation in preterm infants with respiratory distress syndrome.

The study was conducted on a total of 40 preterm infants, 34 weeks gestational age or less, having RDS that needed intubation and mechanical ventilation within the first 72 h after their birth at the NICU of Mansoura University Children's Hospital during the period from July 2020 to July 2022. Infants included were randomly assigned into two groups, Group A who were subjected to LRM using HFOV (20 cases) and Group B who were subjected to LRM using VTV/AC (20 cases). TGF-β1 level was measured in BAL samples of all studied infants at two time points; before lung recruitment maneuver and at day 5 after lung recruitment or just before extubation if extubation occurs earlier than 5 days.

Lung recruitment maneuver had no significant effect on time to extubation. Both groups showed no significant difference in rate of prematurity complications nor delta change of TFG-β1 level in tracheal aspirate of those preterm infants measured before lung recruitment and five days after recruitment or at extubation when extubation occurred earlier.

Lung recruitment maneuver was not associated with significant difference between both groups of preterm infants. The results obtained from our study, being the first of its kind to compare the effect of lung recruitment, provide a promising research area for further investigations.