Sustained Lung Inflation in Preterm Infants with Signs of Respiratory Distress: A Randomized Controlled Trial

Area of Science:

• Neonatal Medicine
• Pediatric Respiratory Care
• Clinical Trials

Background:

• Sustained lung inflation (SI) has been explored as an alternative or adjunct to positive pressure ventilation (PPV) in neonatal resuscitation.
• This study focuses on preterm infants who did not require immediate PPV but developed respiratory distress shortly after birth.

Purpose of the Study:

• To investigate the impact of SI on mortality and common morbidities in preterm infants experiencing early respiratory distress.

Main Methods:

• A double-blind randomized clinical trial involving 74 preterm infants (28-33 6/7 weeks gestation).
• Infants were randomized to receive either nCPAP alone or a 10-second SI (20 cmH2O) followed by nCPAP.
• Respiratory distress signs appeared 5-10 minutes post-birth.

Main Results:

• The SI group showed a significantly lower need for surfactant administration (P=0.003) and a shorter hospital stay (P=0.005).
• However, the SI group required longer duration of nCPAP (P=0.003).
• No significant differences were observed in the need for or duration of mechanical ventilation or other secondary outcomes.

Conclusions:

• Applying SI in the initial minutes of life for preterm infants with early respiratory distress can decrease the need for exogenous surfactant and shorten hospital stays.
• Further research is recommended to explore SI's role in managing Respiratory Distress Syndrome (RDS) and its long-term effects on cardiopulmonary and neurodevelopmental outcomes.