title: Do Sustained Lung Inflations during Neonatal Resuscitation Affect Cerebral Blood Volume in Preterm Infants? A Randomized Controlled Pilot Study.
abstract: BACKGROUND
  Sustained lung inflations (SLI) during neonatal resuscitation may promote alveolar recruitment in preterm infants. While most of the studies focus on respiratory outcome, the impact of SLI on the brain hasn't been investigated yet.
  
  
  OBJECTIVE
  Do SLI affect cerebral blood volume (CBV) in preterm infants?
  
  
  METHODS
  Preterm infants of gestation 28 weeks 0 days to 33 weeks 6 days with requirement for respiratory support (RS) were included in this randomized controlled pilot trial. Within the first 15 minutes after birth near-infrared spectroscopy (NIRS) measurements using 'NIRO-200-NX' (Hamamatsu, Japan) were performed to evaluate changes in CBV and cerebral tissue oxygenation. Two groups were compared based on RS: In SLI group RS was given by applying 1-3 SLI (30 cmH2O for 15 s) continued by respiratory standard care. Control group received respiratory standard care only.
  
  
  RESULTS
  40 infants (20 in each group) with mean gestational age of 32 weeks one day (±2 days) and birth weight of 1707 (±470) g were included. In the control group ΔCBV was significantly decreasing, whereas in SLI group ΔCBV showed similar values during the whole period of 15 minutes. Comparing both groups within the first 15 minutes ΔCBV showed a tendency toward different overall courses (p = 0.051).
  
  
  CONCLUSIONS
  This is the first study demonstrating an impact of SLI on CBV. Further studies are warranted including reconfirmation of the present findings in infants with lower gestational age. Future investigations on SLI should not only focus on respiratory outcome but also on the consequences on the developing brain.
  
  
  BACKGROUND
  German Clinical Trials Register DRKS00005161 https://drks-neu.uniklinik-freiburg.de/drks_web/setLocale_EN.do.
authors.affiliation: Research Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, Austria; Research Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, Austria; Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schwaberger
authors.affiliation: Research Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, Austria; Research Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, Austria; Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Pichler
authors.affiliation: Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Avian
authors.affiliation: Research Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, Austria; Research Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, Austria; Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria.
authors.forename: Corinna
authors.initials: C
authors.lastname: Binder-Heschl
authors.affiliation: Research Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, Austria; Research Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, Austria; Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria.
authors.forename: Nariae
authors.initials: N
authors.lastname: Baik
authors.affiliation: Research Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, Austria; Research Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, Austria; Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria.
authors.forename: Berndt
authors.initials: B
authors.lastname: Urlesberger
mesh_terms: D001810:Blood Volume; D001921:Brain / Q000098:blood supply* / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000503:physiopathology*; D010100:Oxygen / Q000378:metabolism; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D010865:Pilot Projects; D012121:Respiration, Artificial / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000503:physiopathology / Q000628:therapy*; D012151:Resuscitation
chemical_list: D010100:Oxygen