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- Title
Sustained Lung Inflation in Pre-term Infants at Birth: A Randomized Controlled Trial.
- Authors
Hamd, Walaa A Abuel; Sherbiny, Douaa E El; Houchi, Salma Z El; Iskandar, Iman F; Akmal, Dina M; Abuel Hamd, Walaa A; El Sherbiny, Douaa E; El Houchi, Salma Z
- Abstract
<bold>Background: </bold>Invasive mechanical ventilation (IMV) of pre-term infants may be associated with high rate of mortality and iatrogenic complications in low- and middle-income countries. Sustained lung inflation (SLI) may help to reduce their need for IMV.<bold>Methods: </bold>This randomized controlled trial included 160 infants with gestational age (GA) ≥27 and ≤32 weeks who were randomly assigned to receive either SLI; using a pressure of 20 cmH2O for 15 s followed by nasal continuous positive airway pressure (CPAP) of 5 cmH2O or nasal CPAP alone, through an appropriate mask and a T-piece resuscitator. Primary outcome was the need for IMV in the first 72 h of life.<bold>Results: </bold>There was no difference in the primary outcome between SLI group; 55% (44 out of 80) and the control group; 65% (52 out of 80) [odds ratio (OR): 0.623, 95% confidence interval (CI): 0.33-1.18; p = 0.145]. However, SLI significantly reduced the primary outcome in the sicker infants; who had clinical eligibility criteria (CEC; OR: 0.224, 95% CI: 0.076-0.663; p = 0.005) and in the smaller babies; whose GA was <30 weeks (OR: 0.183, 95% CI: 0.053-0.635; p = 0.005).<bold>Conclusion: </bold>SLI was not harmful. Although, it did not lead to reduction in the need for IMV in the first 72 h of life in pre-term infants with GA ≥27 and ≤32 weeks, SLI reduced this outcome in the subgroup of infants with CEC and those with GA <30 weeks. Future trials are needed to investigate the effect of SLI on these two subgroups.<bold>Trial Registration: </bold>Clinical trials.gov, NCT03518762. https://www.clinicaltrials.gov/ct2/show/NCT03518762?term=NCT03518762&rank=1.
- Subjects
PREMATURE infants; RANDOMIZED controlled trials; RETROLENTAL fibroplasia; CONTINUOUS positive airway pressure; LUNGS; PRICE inflation; RESPIRATORY distress syndrome treatment; RESEARCH; RESEARCH methodology; GESTATIONAL age; MEDICAL cooperation; EVALUATION research; ARTIFICIAL respiration; COMPARATIVE studies
- Publication
Journal of Tropical Pediatrics, 2021, Vol 67, Issue 1, p1
- ISSN
0142-6338
- Publication type
journal article
- DOI
10.1093/tropej/fmaa097