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REVIEW
E E Foglia, E A Jensen, H Kirpalani
Bronchopulmonary dysplasia (BPD) is the most common chronic respiratory complication of preterm birth. Preterm infants are at risk for acute lung injury immediately after birth, which predisposes to BPD. In this article, we review the current evidence for interventions applied during neonatal transition (delivery room and first postnatal hours of life) to prevent BPD in extremely preterm infants: continuous positive airway pressure (CPAP), sustained lung inflation, supplemental oxygen use during neonatal resuscitation, and surfactant therapy including less-invasive surfactant administration...
November 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
#22
JOURNAL ARTICLE
Neeraj Gupta, Ramesh Agarwal
No abstract text is available yet for this article.
March 2017: Acta Paediatrica
#23
JOURNAL ARTICLE
Gianluca Lista, Francesco Cavigioli, Paola Azzurra La Verde, Francesca Castoldi, Ilia Bresesti, Colin J Morley
BACKGROUND: A sustained inflation (SI) at birth in preterm babies may be ineffective unless the infants breathe. Gain in lung volume is associated with breathing during delivery room non-invasive management. OBJECTIVE: To describe the breathing patterns of preterm infants during an SI and correlate to a calculated gain in lung volume. METHODS: Retrospective observational study. Data collected from a respiratory function monitor during SI (25 cmH2O for 15 s then PEEP at 5 cmH2O) through a face mask in preterm infants (gestational age [GA] ≤31 weeks)...
2017: Neonatology
#24
RANDOMIZED CONTROLLED TRIAL
Paveewan Jiravisitkul, Sasivimol Rattanasiri, Pracha Nuntnarumit
AIM: To compare the effects of sustained lung inflation (SLI) vs. standard resuscitation on physiologic responses of preterm infants during resuscitation. METHODS: 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 25cmH2 O 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...
February 2017: Resuscitation
#25
JOURNAL ARTICLE
David G Tingay, Anushi Rajapaksa, Emanuela Zannin, Prue M Pereira-Fantini, Raffaele L Dellaca, Elizabeth J Perkins, Cornelis E E Zonneveld, Andy Adler, Don Black, Inéz Frerichs, Anna Lavizzari, Magdy Sourial, Bartłomiej Grychtol, Fabio Mosca, Peter G Davis
Respiratory transition at birth involves rapidly clearing fetal lung liquid and preventing efflux back into the lung while aeration is established. We have developed a sustained inflation (SIOPT ) individualized to volume response and a dynamic tidal positive end-expiratory pressure (PEEP) (open lung volume, OLV) strategy that both enhance this process. We aimed to compare the effect of each with a group managed with PEEP of 8 cmH2 O and no recruitment maneuver (No-RM), on gas exchange, lung mechanics, spatiotemporal aeration, and lung injury in 127 ± 1 day preterm lambs...
January 1, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
#26
REVIEW
Clyde J Wright, Richard A Polin
Noninvasive support of preterm infants with respiratory distress is an evidenced-based strategy to decrease the incidence of bronchopulmonary dysplasia. Continuous positive airway pressure (CPAP) is the only noninvasive strategy with sufficient evidence to support its use in acute respiratory distress syndrome. It is unclear if one method for delivering CPAP is superior to another. Future research will focus on strategies (eg, sustained lung inflation, and administration of surfactant using a thin plastic catheter) that increase the likelihood of success with CPAP, especially in infants with a gestational age of less than 26 weeks...
December 2016: Clinics in Perinatology
#27
REVIEW
Elizabeth E Foglia, Arjan B Te Pas
Lung aeration is the most critical task newborns must accomplish after birth. Almost all extremely preterm infants require respiratory support during this process, but the best method to promote lung aeration in preterm infants is unknown. The current standard practice is intermittent positive pressure ventilation with positive end-expiratory pressure. Sustained inflation is a promising alternative strategy for lung liquid clearance and aeration. Here we review the physiologic rationale for sustained inflation and the available clinical evidence for sustained inflation in preterm infants...
December 2016: Clinics in Perinatology
#28
RANDOMIZED CONTROLLED TRIAL
Giovanni Vento, Roberta Pastorino, Luca Boni, Francesco Cota, Virgilio Carnielli, Filip Cools, Carlo Dani, Fabio Mosca, Jane Pillow, Graeme Polglase, Paolo Tagliabue, Anton H van Kaam, Maria Luisa Ventura, Milena Tana, Chiara Tirone, Claudia Aurilia, Alessandra Lio, Cinzia Ricci, Alessandro Gambacorta, Chiara Consigli, Danila D'Onofrio, Camilla Gizzi, Luca Massenzi, Viviana Cardilli, Alessandra Casati, Roberto Bottino, Federica Pontiggia, Elena Ciarmoli, Stefano Martinelli, Laura Ilardi, Mariarosa Colnaghi, Piero Giuseppe Matassa, Valentina Vendettuoli, Paolo Villani, Francesca Fusco, Diego Gazzolo, Alberto Ricotti, Federica Ferrero, Ilaria Stasi, Rosario Magaldi, Gianfranco Maffei, Giuseppe Presta, Roberto Perniola, Francesco Messina, Giovanna Montesano, Chiara Poggi, Lucio Giordano, Enza Roma, Carolina Grassia, Gaetano Ausanio, Fabrizio Sandri, Giovanna Mescoli, Francesco Giura, Giampaolo Garani, Agostina Solinas, Maria Lucente, Gabriella Nigro, Antonello Del Vecchio, Flavia Petrillo, Luigi Orfeo, Lidia Grappone, Lorenzo Quartulli, Antonio Scorrano, Hubert Messner, Alex Staffler, Giancarlo Gargano, Eleonora Balestri, Stefano Nobile, Caterina Cacace, Valerio Meli, Sara Dallaglio, Betta Pasqua, Loretta Mattia, Eloisa Gitto, Marcello Vitaliti, Maria Paola Re, Stefania Vedovato, Alessandra Grison, Alberto Berardi, Francesco Torcetta, Isotta Guidotti, Sandra di Fabio, Eugenia Maranella, Isabella Mondello, Stefano Visentin, Francesca Tormena
BACKGROUND: Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an "optimal" functional residual capacity...
August 18, 2016: Trials
#29
RANDOMIZED CONTROLLED TRIAL
Mohamed S El-Chimi, Hisham A Awad, Tarek M El-Gammasy, Ola G El-Farghali, Mohamed T Sallam, Dina M Shinkar
AIM: To evaluate efficacy and safety of delivery room (DR) sustained lung inflation (SLI) in resuscitation of preterm neonates. METHODS: Randomized Controlled Trial including 112 preterm infants randomized to either SLI (n = 57) using T-piece resuscitator [maximum three inflations with maximum pressure of 30 cmH2 O for 15 s followed by continuous positive airway pressure (CPAP) of 5-7 cmH2 O] or conventional bag/mask inflation (CBMI) (n = 55) using traditional self-inflating bag (maximum pressure of 40 cmH2 O at a rate of 40-60 per min)...
June 2017: Journal of Maternal-fetal & Neonatal Medicine
#30
REVIEW
Gianluca Lista, Paola Azzurra La Verde, Francesca Castoldi
A noninvasive approach in the delivery room in place of intubation and mechanical ventilation can reduce rates of bronchopulmonary dysplasia and death. Nevertheless, the rate of nasal continuous positive airway pressure failure still remains high. In order to prevent lung injury and to enhance the success of continuous positive airway pressure, sustained inflation (administration by face mask or nasopharyngeal tube of a high peak pressure of 20-25 cm H2O, maintained for 10-15 s) has been recently proposed to establish an early and efficient functional residual capacity in the delivery room...
2016: Neonatology
#31
JOURNAL ARTICLE
Arjan B Te Pas, Marcus J Kitchen, Katie Lee, Megan J Wallace, Andreas Fouras, Robert A Lewis, Naoto Yagi, Kentaro Uesugi, Stuart B Hooper
BACKGROUND: A sustained inflation (SI) facilitates lung aeration, but the most effective pressure and duration are unknown. We investigated the effect of gestational age (GA) and airway liquid volume on the required inflation pressure and SI duration. METHODS: Rabbit kittens were delivered at 27, 29, and 30 d gestation, intubated and airway liquid was aspirated. Either no liquid (control) or 30 ml/kg of liquid was returned to the airways. Lung gas volumes were measured by plethysmography and phase-contrast X-ray-imaging...
July 2016: Pediatric Research
#32
REVIEW
G Lista, F Cavigioli, F Castoldi, L J I Zimmermann
Application of nasal continuous positive airway pressure (nCPAP) in the delivery room is a valid alternative to mechanical ventilation in the management of respiratory failure of preterm infants, with reduced occurrence of bronchopulmonary dysplasia and death. nCPAP at birth is still burdened by a high failure rate. Sustained inflation appears to be an intriguing approach to allow the respiratory transition at birth by clearing the lung fluid, thus obtaining an adequate functional residual capacity. This may enhance nCPAP success...
June 2016: Seminars in Fetal & Neonatal Medicine
#33
JOURNAL ARTICLE
David G Tingay, Anushi Rajapaksa, Karen McCall, Cornelis E E Zonneveld, Don Black, Elizabeth Perkins, Magdy Sourial, Anna Lavizzari, Peter G Davis
BACKGROUND: To describe the interrelationship between antenatal steroids, exogenous surfactant, and two approaches to lung recruitment at birth on oxygenation and respiratory system compliance (Cdyn) in preterm lambs. METHODS: Lambs (n = 63; gestational age 127 ± 1 d) received either surfactant at 10-min life (Surfactant), antenatal corticosteroids (Steroid), or neither (Control). Within each epoch lambs were randomly assigned to a 30-s 40 cmH2O sustained inflation (SI) or an initial stepwise positive end-expiratory pressure (PEEP) open lung ventilation (OLV) maneuver at birth...
June 2016: Pediatric Research
#34
RANDOMIZED CONTROLLED TRIAL
D Mercadante, M Colnaghi, V Polimeni, E Ghezzi, M Fumagalli, D Consonni, F Mosca
OBJECTIVE: To assess the need for respiratory support in late preterm infants treated with sustained lung inflation (SLI) at birth. STUDY DESIGN: In this controlled trial, we randomly assigned infants born at 34(+0) to 36(+6) weeks of gestation to receive SLI (25 cmH2O for 15 s) at birth, followed by continuous positive airway pressure (CPAP) or assistance according to the recommendations of the American Academy of Pediatrics. The primary outcome was the need for any type of respiratory support...
June 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
#35
JOURNAL ARTICLE
David G Tingay, Anna Lavizzari, Cornelis E E Zonneveld, Anushi Rajapaksa, Emanuela Zannin, Elizabeth Perkins, Don Black, Magdy Sourial, Raffaele L Dellacà, Fabio Mosca, Andy Adler, Bartłomiej Grychtol, Inéz Frerichs, Peter G Davis
A sustained first inflation (SI) at birth may aid lung liquid clearance and aeration, but the impact of SI duration relative to the volume-response of the lung is poorly understood. We compared three SI strategies: 1) variable duration defined by attaining volume equilibrium using real-time electrical impedance tomography (EIT; SIplat); 2) 30 s beyond equilibrium (SIlong); 3) short 30-s SI (SI30); and 4) positive pressure ventilation without SI (no-SI) on spatiotemporal aeration and ventilation (EIT), gas exchange, lung mechanics, and regional early markers of injury in preterm lambs...
November 15, 2015: American Journal of Physiology. Lung Cellular and Molecular Physiology
#36
RANDOMIZED CONTROLLED TRIAL
Bernhard Schwaberger, Gerhard Pichler, Alexander Avian, Corinna Binder-Heschl, Nariae Baik, Berndt Urlesberger
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...
2015: PloS One
#37
COMPARATIVE STUDY
Tereza Lamberska, Marketa Luksova, Jan Smisek, Jana Vankova, Richard Plavka
AIM: Standard resuscitation guidelines are based on data from a range of gestational ages. We sought to evaluate the effectiveness of our delivery room resuscitation protocol across a range of gestational ages in preterm infants born at <29 weeks. METHODS: We performed an observational study of prospectively collected video recordings of 73 preterm infants. The percentage of bradycardic patients, time to reach target oxygen saturation and the extent of all interventions were compared between three gestational age groups: 22-24 weeks (n = 22), 25-26 weeks (n = 27) and 27-28 weeks (n = 24)...
April 2016: Acta Paediatrica
#38
JOURNAL ARTICLE
David G Tingay, Anushi Rajapaksa, C Elroy Zonneveld, Don Black, Elizabeth J Perkins, Andy Adler, Bartłomiej Grychtol, Anna Lavizzari, Inéz Frerichs, Valerie A Zahra, Peter G Davis
Ineffective aeration during the first inflations at birth creates regional aeration and ventilation defects, initiating injurious pathways. This study aimed to compare a sustained first inflation at birth or dynamic end-expiratory supported recruitment during tidal inflations against ventilation without intentional recruitment on gas exchange, lung mechanics, spatiotemporal regional aeration and tidal ventilation, and regional lung injury in preterm lambs. Lambs (127 ± 2 d gestation), instrumented at birth, were ventilated for 60 minutes from birth with either lung-protective positive pressure ventilation (control) or as per control after either an initial 30 seconds of 40 cm H2O sustained inflation (SI) or an initial stepwise end-expiratory pressure recruitment maneuver during tidal inflations (duration 180 s; open lung ventilation [OLV])...
February 2016: American Journal of Respiratory Cell and Molecular Biology
#39
JOURNAL ARTICLE
Hans Fuchs
Of 680 000 infants born in Germany a year roughly 10% are preterm and 1% are very preterm. They are treated in around 150 level 1 perinatal centers and there are various credos how to best treat the ELGAN infant. However, many centers include the use of a sustained inflation for lung aeration in the standard protocol of delivery room care in Germany. As a result of the large studies on delivery room care, a trend for earlier or prophylactic surfactant in the most immature infants can be observed, however, surfactant is increasingly given in a new less invasive way called LISA...
June 29, 2015: Acta Bio-medica: Atenei Parmensis
#40
RANDOMIZED CONTROLLED TRIAL
Elizabeth E Foglia, Louise S Owen, Marta Thio, Sarah J Ratcliffe, Gianluca Lista, Arjan Te Pas, Helmut Hummler, Vinay Nadkarni, Anne Ades, Michael Posencheg, Martin Keszler, Peter Davis, Haresh Kirpalani
BACKGROUND: Extremely preterm infants require assistance recruiting the lung to establish a functional residual capacity after birth. Sustained inflation (SI) combined with positive end expiratory pressure (PEEP) may be a superior method of aerating the lung compared with intermittent positive pressure ventilation (IPPV) with PEEP in extremely preterm infants. The Sustained Aeration of Infant Lungs (SAIL) trial was designed to study this question. METHODS/DESIGN: This multisite prospective randomized controlled unblinded trial will recruit 600 infants of 23 to 26 weeks gestational age who require respiratory support at birth...
March 15, 2015: Trials
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