Gradual Aeration at Birth Is More Lung Protective Than a Sustained Inflation in Preterm Lambs
David G Tingay, Prue M Pereira-Fantini, Regina Oakley, Karen E McCall, Elizabeth J Perkins, Martijn Miedema, Magdy Sourial, Jessica Thomson, Andreas Waldmann, Raffaele L Dellaca, Peter G Davis, Peter A Dargaville
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE | AMER THORACIC SOC | Published : 2019
Rationale: The preterm lung is susceptible to injury during transition to air breathing at birth. It remains unclear whether rapid or gradual lung aeration at birth causes less lung injury.Objectives: To examine the effect of gradual and rapid aeration at birth on: 1) the spatiotemporal volume conditions of the lung; and 2) resultant regional lung injury.Methods: Preterm lambs (125 ± 1 d gestation) were randomized at birth to receive: 1) tidal ventilation without an intentional recruitment (no-recruitment maneuver [No-RM]; n = 19); 2) sustained inflation (SI) until full aeration (n = 26); or 3) tidal ventilation with an initial escalating/de-escalating (dynamic) positive end-expiratory press..View full abstract
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 Practitioner Fellowship
Supported by a National Health and Medical Research Council Project Grant (1009287) and the Victorian Government Operational Infrastructure Support Program (Melbourne, Victoria, Australia), a National Health and Medical Research Council Clinical Career Development Fellowship (1053889; D.G.T.), and a National Health and Medical Research Council Program Grant (606789) and a National Health and Medical Research Council Practitioner Fellowship (556600; P.G.D.). Chiesi Farmaceutici S.p.A. provided the Curosurf used in this study as part of an unrestricted grant (D.G.T.) at the Murdoch Childrens Research Institute.