Premium
Sustained lung inflation at birth via short binasal prong in very low birth weight preterm infants: A retrospective study
Author(s) -
Buyuktiryaki Mehmet,
Kanmaz Hayriye G.,
Okur Nilufer,
Bezirganoglu Handan,
Ozer Bekmez Buse,
Simsek Gulsum Kadioglu,
Canpolat Fuat E.,
Oguz Suna S.,
Tayman Cuneyt
Publication year - 2018
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24130
Subject(s) - medicine , continuous positive airway pressure , bronchopulmonary dysplasia , gestational age , respiratory distress , pediatrics , birth weight , low birth weight , mechanical ventilation , anesthesia , pregnancy , biology , obstructive sleep apnea , genetics
Background and Objectives It is believed, that sustained lung inflation (SLI) at birth in preterm infants reduces the need for mechanical ventilation (MV) and improves respiratory outcomes. The aim of this study was to compare need for MV in preterm infants at high risk for respiratory distress syndrome (RDS) after prophylactic SLI via short binasal prongs at birth combined with early nasal continuous positive airway pressure (nCPAP) versus nCPAP alone. Methods Medical records of infants born at 26 0/7 to 29 6/7 weeks gestation through 2015 and 2017 were retrospectively assessed. Infants who get sustained inflations at 25 cmH 2 O pressure for 15 s following delivery via binasal short prongs comprised the study group. Gestational age matched infants who was supported solely with nCPAP (6 cmH 2 O PEEP) comprised the control group. Early rescue surfactant (200 mg/kg poractant alfa) was delivered using the less invasive surfactant administration technique in infants with established RDS. Results A total of 215 infants were analyzed. Fewer infants in the SLI group required MV within the first 72 h of life compared to the control group (25.7% vs 56.9%, P < 0.001). In multiple logistic regression analysis, SLI emerged as an independent factor for reduced MV need. Bronchopulmonary dysplasia (BPD) incidence including mild BPD was significantly lower in the SLI group (31.9% vs 48%, P = 0.01); however, moderate and severe BPD rates did not reach to a statistical significance (11.5% vs 20.6%, P = 0.06). Conclusion Prophylactic SLI maneuver at birth for preterm infants with impending RDS reduces the need for MV with no adverse effects.