Sustained Inflation Versus Intermittent Positive Pressure Ventilation for Preterm Infants at Birth: Respiratory Function and Vital Sign Measurements - 15/11/21
, Haresh Kirpalani, BM, MSc 1, Sarah J. Ratcliffe, PhD 2, Peter G. Davis, MD, FRACP 3, Marta Thio, MD, PhD 3, Helmut Hummler, MD, MBA 4, Gianluca Lista, MD, PhD 5, Francesco Cavigioli, MD 5, Georg M. Schmölzer, MD, PhD 6, Martin Keszler, MD 7, Arjan B. te Pas, MD, PhD 8Abstract |
Objective |
To characterize respiratory function monitor (RFM) measurements of sustained inflations and intermittent positive pressure ventilation (IPPV) delivered noninvasively to infants in the Sustained Aeration of Infant Lungs (SAIL) trial and to compare vital sign measurements between treatment arms.
Study design |
We analyzed RFM data from SAIL participants at 5 trial sites. We assessed tidal volumes, rates of airway obstruction, and mask leak among infants allocated to sustained inflations and IPPV, and we compared pulse rate and oxygen saturation measurements between treatment groups.
Results |
Among 70 SAIL participants (36 sustained inflations, 34 IPPV) with RFM measurements, 40 (57%) were spontaneously breathing prior to the randomized intervention. The median expiratory tidal volume of sustained inflations administered was 5.3 mL/kg (IQR 1.1-9.2). Significant mask leak occurred in 15% and airway obstruction occurred during 17% of sustained inflations. Among 34 control infants, the median expiratory tidal volume of IPPV inflations was 4.3 mL/kg (IQR 1.3-6.6). Mask leak was present in 3%, and airway obstruction was present in 17% of IPPV inflations. There were no significant differences in pulse rate or oxygen saturation measurements between groups at any point during resuscitation.
Conclusion |
Expiratory tidal volumes of sustained inflations and IPPV inflations administered in the SAIL trial were highly variable in both treatment arms. Vital sign values were similar between groups throughout resuscitation. Sustained inflation as operationalized in the SAIL trial was not superior to IPPV to promote lung aeration after birth in this study subgroup.
Trial Registration |
Clinicaltrials.gov: NCT02139800.
Le texte complet de cet article est disponible en PDF.Keywords : preterm, sustained inflation, resuscitation
Abbreviations : IPPV, RFM, SAIL, Vte, Vti
Plan
| Supported by the National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): R03HD 086655-01A1 (to E.F.), K23HD084727-01A1 (to E.F.), and U01-HD072906-01A1 (to H.K.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors declare no conflicts of interest. |
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| Portions of this study were presented at the Pediatric Academic Societies annual meeting, April 24-May 1, 2019, Baltimore, Maryland. |
Vol 239
P. 150 - décembre 2021 Retour au numéro
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