Sustained lung inflation at birth for preterm infants: A randomized clinical trial

Gianluca Lista, Luca Boni, Fabio Scopesi, Fabio Mosca, Daniele Trevisanuto, Hubert Messner, Giovanni Vento, Rosario Magaldi, Antonio Del Vecchio, Massimo Agosti, Camilla Gizzi, Fabrizio Sandri, Paolo Biban, Massimo Bellettato, Diego Gazzolo, Antonio Boldrini, Carlo Dani

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

BACKGROUND: Studies suggest that giving newly born preterm infants sustained lung inflation abstract (SLI) may decrease their need for mechanical ventilation (MV) and improve their respiratory outcomes. METHODS: We randomly assigned infants born at 25 weeks 0 days to 28 weeks 6 days of gestation to receive SLI (25 cm H2O for 15 seconds) followed by nasal continuous positive airway pressure (nCPAP) or nCPAP alone in the delivery room. SLI and nCPAP were delivered by using a neonatal mask and a T-piece ventilator. The primary end point was the need for MV in the first 72 hours of life. The secondary end points included the need for respiratory supports and survival without bronchopulmonary dysplasia (BPD). RESULTS: A total of 148 infants were enrolled in the SLI group and 143 in the control group. Significantly fewer infants were ventilated in the first 72 hours of life in the SLI group (79 of 148 [53%]) than in the control group (93 of 143 [65%]); unadjusted odds ratio: 0.62 [95% confidence interval: 0.38-0.99]; P = .04). The need for respiratory support and survival without BPD did not differ between the groups. Pneumothorax occurred in 1% (n = 2) of infants in the control group compared with 6% (n = 9) in the SLI group, with an unadjusted odds ratio of 4.57 (95% confidence interval: 0.97-21.50; P = .06). CONCLUSIONS: SLI followed by nCPAP in the delivery room decreased the need for MV in the first 72 hours of life in preterm infants at high risk of respiratory distress syndrome compared with nCPAP alone but did not decrease the need for respiratory support and the occurrence of BPD.

Original languageEnglish
Pages (from-to)e457-e464
JournalPediatrics
Volume135
Issue number2
DOIs
Publication statusPublished - Feb 1 2015

Fingerprint

Economic Inflation
Premature Infants
Continuous Positive Airway Pressure
Randomized Controlled Trials
Parturition
Lung
Bronchopulmonary Dysplasia
Artificial Respiration
Delivery Rooms
Control Groups
Odds Ratio
Confidence Intervals
Pneumothorax
Mechanical Ventilators
Masks
Pregnancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Lista, G., Boni, L., Scopesi, F., Mosca, F., Trevisanuto, D., Messner, H., ... Dani, C. (2015). Sustained lung inflation at birth for preterm infants: A randomized clinical trial. Pediatrics, 135(2), e457-e464. https://doi.org/10.1542/peds.2014-1692

Sustained lung inflation at birth for preterm infants : A randomized clinical trial. / Lista, Gianluca; Boni, Luca; Scopesi, Fabio; Mosca, Fabio; Trevisanuto, Daniele; Messner, Hubert; Vento, Giovanni; Magaldi, Rosario; Del Vecchio, Antonio; Agosti, Massimo; Gizzi, Camilla; Sandri, Fabrizio; Biban, Paolo; Bellettato, Massimo; Gazzolo, Diego; Boldrini, Antonio; Dani, Carlo.

In: Pediatrics, Vol. 135, No. 2, 01.02.2015, p. e457-e464.

Research output: Contribution to journalArticle

Lista, G, Boni, L, Scopesi, F, Mosca, F, Trevisanuto, D, Messner, H, Vento, G, Magaldi, R, Del Vecchio, A, Agosti, M, Gizzi, C, Sandri, F, Biban, P, Bellettato, M, Gazzolo, D, Boldrini, A & Dani, C 2015, 'Sustained lung inflation at birth for preterm infants: A randomized clinical trial', Pediatrics, vol. 135, no. 2, pp. e457-e464. https://doi.org/10.1542/peds.2014-1692
Lista G, Boni L, Scopesi F, Mosca F, Trevisanuto D, Messner H et al. Sustained lung inflation at birth for preterm infants: A randomized clinical trial. Pediatrics. 2015 Feb 1;135(2):e457-e464. https://doi.org/10.1542/peds.2014-1692
Lista, Gianluca ; Boni, Luca ; Scopesi, Fabio ; Mosca, Fabio ; Trevisanuto, Daniele ; Messner, Hubert ; Vento, Giovanni ; Magaldi, Rosario ; Del Vecchio, Antonio ; Agosti, Massimo ; Gizzi, Camilla ; Sandri, Fabrizio ; Biban, Paolo ; Bellettato, Massimo ; Gazzolo, Diego ; Boldrini, Antonio ; Dani, Carlo. / Sustained lung inflation at birth for preterm infants : A randomized clinical trial. In: Pediatrics. 2015 ; Vol. 135, No. 2. pp. e457-e464.
@article{b5e6dc4214194539a5c8b96ac3b11be2,
title = "Sustained lung inflation at birth for preterm infants: A randomized clinical trial",
abstract = "BACKGROUND: Studies suggest that giving newly born preterm infants sustained lung inflation abstract (SLI) may decrease their need for mechanical ventilation (MV) and improve their respiratory outcomes. METHODS: We randomly assigned infants born at 25 weeks 0 days to 28 weeks 6 days of gestation to receive SLI (25 cm H2O for 15 seconds) followed by nasal continuous positive airway pressure (nCPAP) or nCPAP alone in the delivery room. SLI and nCPAP were delivered by using a neonatal mask and a T-piece ventilator. The primary end point was the need for MV in the first 72 hours of life. The secondary end points included the need for respiratory supports and survival without bronchopulmonary dysplasia (BPD). RESULTS: A total of 148 infants were enrolled in the SLI group and 143 in the control group. Significantly fewer infants were ventilated in the first 72 hours of life in the SLI group (79 of 148 [53{\%}]) than in the control group (93 of 143 [65{\%}]); unadjusted odds ratio: 0.62 [95{\%} confidence interval: 0.38-0.99]; P = .04). The need for respiratory support and survival without BPD did not differ between the groups. Pneumothorax occurred in 1{\%} (n = 2) of infants in the control group compared with 6{\%} (n = 9) in the SLI group, with an unadjusted odds ratio of 4.57 (95{\%} confidence interval: 0.97-21.50; P = .06). CONCLUSIONS: SLI followed by nCPAP in the delivery room decreased the need for MV in the first 72 hours of life in preterm infants at high risk of respiratory distress syndrome compared with nCPAP alone but did not decrease the need for respiratory support and the occurrence of BPD.",
author = "Gianluca Lista and Luca Boni and Fabio Scopesi and Fabio Mosca and Daniele Trevisanuto and Hubert Messner and Giovanni Vento and Rosario Magaldi and {Del Vecchio}, Antonio and Massimo Agosti and Camilla Gizzi and Fabrizio Sandri and Paolo Biban and Massimo Bellettato and Diego Gazzolo and Antonio Boldrini and Carlo Dani",
year = "2015",
month = "2",
day = "1",
doi = "10.1542/peds.2014-1692",
language = "English",
volume = "135",
pages = "e457--e464",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "2",

}

TY - JOUR

T1 - Sustained lung inflation at birth for preterm infants

T2 - A randomized clinical trial

AU - Lista, Gianluca

AU - Boni, Luca

AU - Scopesi, Fabio

AU - Mosca, Fabio

AU - Trevisanuto, Daniele

AU - Messner, Hubert

AU - Vento, Giovanni

AU - Magaldi, Rosario

AU - Del Vecchio, Antonio

AU - Agosti, Massimo

AU - Gizzi, Camilla

AU - Sandri, Fabrizio

AU - Biban, Paolo

AU - Bellettato, Massimo

AU - Gazzolo, Diego

AU - Boldrini, Antonio

AU - Dani, Carlo

PY - 2015/2/1

Y1 - 2015/2/1

N2 - BACKGROUND: Studies suggest that giving newly born preterm infants sustained lung inflation abstract (SLI) may decrease their need for mechanical ventilation (MV) and improve their respiratory outcomes. METHODS: We randomly assigned infants born at 25 weeks 0 days to 28 weeks 6 days of gestation to receive SLI (25 cm H2O for 15 seconds) followed by nasal continuous positive airway pressure (nCPAP) or nCPAP alone in the delivery room. SLI and nCPAP were delivered by using a neonatal mask and a T-piece ventilator. The primary end point was the need for MV in the first 72 hours of life. The secondary end points included the need for respiratory supports and survival without bronchopulmonary dysplasia (BPD). RESULTS: A total of 148 infants were enrolled in the SLI group and 143 in the control group. Significantly fewer infants were ventilated in the first 72 hours of life in the SLI group (79 of 148 [53%]) than in the control group (93 of 143 [65%]); unadjusted odds ratio: 0.62 [95% confidence interval: 0.38-0.99]; P = .04). The need for respiratory support and survival without BPD did not differ between the groups. Pneumothorax occurred in 1% (n = 2) of infants in the control group compared with 6% (n = 9) in the SLI group, with an unadjusted odds ratio of 4.57 (95% confidence interval: 0.97-21.50; P = .06). CONCLUSIONS: SLI followed by nCPAP in the delivery room decreased the need for MV in the first 72 hours of life in preterm infants at high risk of respiratory distress syndrome compared with nCPAP alone but did not decrease the need for respiratory support and the occurrence of BPD.

AB - BACKGROUND: Studies suggest that giving newly born preterm infants sustained lung inflation abstract (SLI) may decrease their need for mechanical ventilation (MV) and improve their respiratory outcomes. METHODS: We randomly assigned infants born at 25 weeks 0 days to 28 weeks 6 days of gestation to receive SLI (25 cm H2O for 15 seconds) followed by nasal continuous positive airway pressure (nCPAP) or nCPAP alone in the delivery room. SLI and nCPAP were delivered by using a neonatal mask and a T-piece ventilator. The primary end point was the need for MV in the first 72 hours of life. The secondary end points included the need for respiratory supports and survival without bronchopulmonary dysplasia (BPD). RESULTS: A total of 148 infants were enrolled in the SLI group and 143 in the control group. Significantly fewer infants were ventilated in the first 72 hours of life in the SLI group (79 of 148 [53%]) than in the control group (93 of 143 [65%]); unadjusted odds ratio: 0.62 [95% confidence interval: 0.38-0.99]; P = .04). The need for respiratory support and survival without BPD did not differ between the groups. Pneumothorax occurred in 1% (n = 2) of infants in the control group compared with 6% (n = 9) in the SLI group, with an unadjusted odds ratio of 4.57 (95% confidence interval: 0.97-21.50; P = .06). CONCLUSIONS: SLI followed by nCPAP in the delivery room decreased the need for MV in the first 72 hours of life in preterm infants at high risk of respiratory distress syndrome compared with nCPAP alone but did not decrease the need for respiratory support and the occurrence of BPD.

UR - http://www.scopus.com/inward/record.url?scp=84922670307&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922670307&partnerID=8YFLogxK

U2 - 10.1542/peds.2014-1692

DO - 10.1542/peds.2014-1692

M3 - Article

C2 - 25624390

AN - SCOPUS:84922670307

VL - 135

SP - e457-e464

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 2

ER -