Journal article

Aeration strategy at birth influences the physiological response to surfactant in preterm lambs

David Gerald Tingay, Andrea Togo, Prue M Pereira-Fantini, Martijn Miedema, Karen E McCall, Elizabeth J Perkins, Jessica Thomson, Georgie Dowse, Magdy Sourial, Raffaele L Dellaca, Peter G Davis, Peter Anderson Dargaville

Archives of Disease in Childhood - Fetal and Neonatal Edition | BMJ PUBLISHING GROUP | Published : 2019

Abstract

BACKGROUND: The influence of pressure strategies to promote lung aeration at birth on the subsequent physiological response to exogenous surfactant therapy has not been investigated. OBJECTIVES: To compare the effect of sustained inflation (SI) and a dynamic positive end-expiratory pressure (PEEP) manoeuvre at birth on the subsequent physiological response to exogenous surfactant therapy in preterm lambs. METHODS: Steroid-exposed preterm lambs (124-127 days' gestation; n=71) were randomly assigned from birth to either (1) positive-pressure ventilation (PPV) with no recruitment manoeuvre; (2) SI until stable aeration; or (3) 3 min dynamic stepwise PEEP strategy (maximum 14-20 cmH2O; dynamic P..

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Grants

Awarded by National Health and Medical Research Council


Awarded by National Health and Medical Research Council Clinical Career Development Fellowship


Awarded by National Health and Medical Research Council Program Grant


Awarded by National Health and Medical Research Council Practitioner Fellowship


Funding Acknowledgements

This study is supported by a National Health and Medical Research Council Project Grant (Grant ID 1009287) and the Victorian Government Operational Infrastructure Support Program (Melbourne, Australia). DGT is supported by a National Health and Medical Research Council Clinical Career Development Fellowship (Grant ID 1053889). PGD is supported by a National Health and Medical Research Council Program Grant (Grant ID 606789) and by a National Health and Medical Research Council Practitioner Fellowship (Grant ID 556600). Chiesi Farmaceutici (Parma, Italy) provided the Curosurf used in this study as part of an unrestricted grant to DGT at the Murdoch Children's Research Institute. Swisstom (Landquart, Switzerland) manufactured EIT belts custom-built for lambs for this study. All EIT hardware was purchased by Murdoch Children's Research Institute.