TITLE:
Comparison of Respiratory Outcome between Sustained Lung Inflation and Intermittent Positive Ventilation in Preterm Infants Requiring Resuscitation at Birth
AUTHORS:
Lamiaa SH. Rehan, Safaa A. ELMeneza, Heba T. Okda
KEYWORDS:
Sustained Lung Inflation, Preterm Infants, Resuscitation, Delivery Room, Mechanical Ventilation, T-Piece Resuscitator-Self Inflated Bag
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.11 No.1,
March
25,
2021
ABSTRACT: Background: Sustained lung inflation (SLI) would permit lung recruitment immediately after
birth, improving lung mechanics and reducing the need for intubation and subsequent
respiratory support in the neonatal intensive care unit among preterm infants. Aim of the Study: To assess
the efficacy of initial sustained lung inflation compared to standard intermittent positive pressure
ventilation (IPPV) in
preterm infants who need resuscitation in delivery room. Methods: This was prospective randomized observational study that
was conducted in the delivery room and NICU of A in shames University hospital from February 2019 to September
2019. The study included 115 preterm infants between 26 - 32 weeks of
gestation who needed resuscitation at delivery room. The infants were randomly allocated
into 2 groups; SLI group: included the preterm infants who received the SLI at initial
inflation pressure of 25 cm H2O for 15 seconds using the Neopuff/T piece.
IPPV group: preterm infants who received standard resuscitation; IPPV using the
self-inflating bag. The heart rate (HR), oxygen saturation (SpO2), oxygen
requirement, and intubation rate as well as need of surfactant in the delivery room
were assessed. All cases were evaluated after
admission to the NICU for the need of mechanical ventilation in the first 72 hours of life, death in
delivery room or NICU and for bronchopulmonary dysplasia or death at 36 weeks post
menstrual age (PMA). Results: The percentage of preterm infants
who needed resuscitation was 25.5% from the total deliveries during the study period. 56.5% of them received SLI and
43.4% received conventional IPPV. There were no significant differences between
the studied groups regarding gestational age, birth weight. Apgar score, heart rate, oxygen saturation was not significantly
increased in the SLI group at fifth minutes of
age. The percentage of infants who needed
further resuscitation was 20% in SLI group and 12% in the IPPV group. There
were no significant differences in need for surfactant, CPAP or ventilator among
the studied groups. There were
no significant
differences in relation to complications as BPD, air leak or retinopathy and death
between the two groups. Conclusion: This study showed that there was no advantage from use of SLI in delivery
room using T-piece upon the conventional IPPV using self-inflating bag.