Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Sustained lung inflation (SI) is an alternative method for lung recruitment in preterm infants at birth. There is lack of knowledge about the target population who will best benefit from this maneuver. Methods: A total of 160 infants with gestational age {u2265}27{u2264}32 weeks at birth were randomly assigned to receive either SI using a pressure of 20 cmH2O for 15 seconds followed by nasal CPAP of 5 cm H₂O (intervention group) or nasal CPAP alone, of 5 cm H₂O (control group), through an appropriate mask and a T-piece resuscitator. Mechanical ventilation (MV) within the first 72 hours of life was our primary outcome. Other outcomes included broncho-pulmonary dysplasia and death. Results: Although MV in the first 72 hours was not significantly lower in SI group (44 out of 80, 55%) when compared to control group (52 out of 80, 65%); P=0.145, there was a trend towards that. However among infants with gestational age <30 weeks (n=65), MV in the first 72 hours was significantly lower in SI group (19 out of 35, 54.3%), when compared to control group (26 out of 30, 86.7%); P=0.005. Also, among infants who needed advanced resuscitation; with more than oxygen and tactile stimulation (n=98), MV in the first 72 hours was significantly lower in SI group (34 out of 53, 64%) when compared to control group (40 out of 45, 89%); P=0.005. Conclusion: SI decreases the need for MV in the first 72 hours when applied to infants with gestational age <30 weeks or when given as a rescue approach for infants who need advanced resuscitation with more than oxygen and tactile stimulation

Issued also as CD