title: Randomised controlled trial of sustained lung inflation for resuscitation of preterm infants in the delivery room.
abstract: To compare the effects of sustained lung inflation (SLI) vs. standard resuscitation on physiologic responses of preterm infants during resuscitation.
  
  
  
  Preterm infants (25-32 weeks gestational age) requiring positive-pressure ventilation or continuous positive airway pressure were randomly assigned to either the SLI group (SLI at 25cmH2O for 15s) or Non-SLI group (standard resuscitation alone). The heart rate (HR), oxygen saturation (SpO2), oxygen requirement, and intubation rate in the delivery room were evaluated.
  
  
  
  Eighty-one infants were enrolled (SLI group, 43; Non-SLI group, 38). The use of SLI effectively reduced the oxygen requirement. The mean fraction of inspired oxygen 10min after birth was 0.28 (95% CI, 0.26-0.30) in the SLI group and 0.47 (95% CI, 0.43-0.52) in the Non-SLI group (p<0.001). During the first 5min, infants in the SLI group trended towards a higher HR and SpO2than those in the Non-SLI group. The intubation rate in the delivery room was not different between the two groups; however, among infants ≤28 weeks gestational age, the intubation rate was lower in the SLI than Non-SLI group (5 of 17 [29%] vs. 10 of 16 [63%], respectively; p=0.05). The duration of respiratory support, survival without bronchopulmonary dysplasia, and the occurrence of pneumothorax were not different between the groups.
  
  
  
  SLI in infants who require respiratory support appears to be effective in facilitating postnatal transition as determined by HR and SpO2responses, resulting in less oxygen supplementation. Further studies are needed to confirm the benefits of SLI.
authors.affiliation: Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Paveewan
authors.initials: P
authors.lastname: Jiravisitkul
authors.affiliation: Clinical Epidemiology Unit, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Sasivimol
authors.initials: S
authors.lastname: Rattanasiri
authors.affiliation: Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. Electronic address: pracha.nun@mahidol.ac.th.
authors.forename: Pracha
authors.initials: P
authors.lastname: Nuntnarumit
mesh_terms: D003696:Delivery Rooms; D005260:Female; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008176:Lung Volume Measurements; D008297:Male; D010100:Oxygen / Q000008:administration & dosage / Q000032:analysis; D011175:Positive-Pressure Respiration; D012151:Resuscitation / Q000379:methods*
chemical_list: D010100:Oxygen
keywords: Preterm infant; Resuscitation; Sustained lung inflation