Dynamic positive end-expiratory pressure strategies using time and pressure recruitment at birth reduce early expression of lung injury in preterm lambs

DG Tingay; PM Pereira-Fantini; M Miedema; KE McCall; EJ Perkins; G Dowse; N Schinckel; M Sourial; PG Davis

Journal article

Dynamic positive end-expiratory pressure strategies using time and pressure recruitment at birth reduce early expression of lung injury in preterm lambs

DG Tingay, PM Pereira-Fantini, M Miedema, KE McCall, EJ Perkins, G Dowse, N Schinckel, M Sourial, PG Davis

American Journal of Physiology Lung Cellular and Molecular Physiology | AMER PHYSIOLOGICAL SOC | Published : 2022

DOI: 10.1152/ajplung.00047.2022

Abstract

Positive end-expiratory pressure (PEEP) is critical to the preterm lung at birth, but the optimal PEEP level remains uncertain. The objective of this study was to determine the effect of maximum PEEP levels at birth on the physiological and injury response in preterm lambs. Steroid-exposed preterm lambs (124–127 days gestation; n = 65) were randomly assigned from birth to either 1) positive pressure ventilation (PPV) at 8 cmH2O PEEP or 3-min dynamic stepwise PEEP strategy (DynPEEP), with either 2) 20 cmH2O maximum PEEP (10 PEEP second steps) or 3) 14 cmH2O maximum PEEP (20-s steps), all followed by standardized PPV for 90 min. Lung mechanics, gas exchange, regional ventilation and aeration (..

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University of Melbourne Researchers

David Tingay Author

Peter Davis Author

Related Projects (1)

IMPROVED RESPIRATORY SUPPORT AND OUTCOMES FOR VERY PRETERM BABIES

Premature babies are born with lungs that are not developed enough to sustain their breathing needs after birth. As a result, they need inte..

Grants

Awarded by Chiesi Farmaceutici

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) . D.G.T. was supported by a National Health and Medical Research Council Clinical Career Development Fellowship (Grant ID 1053889) . P.G.D. is supported by a National Health and Medical Research Council Program Grant (Grant ID 606789) . P.G.D. is supported by a National Health and Medical Research Council Practitioner Fellowship (Grant ID 556600) . Chiesi Farmaceutici S.p.A. (Parma, Italy) provided the Curosurf used in this study as part of an unrestricted grant to D.G.T. at the Murdoch Children's Research Institute. Swisstom AG (Landquart, Switzerland) manufactured EIT belts custom-built for lambs for this study. All EIT hardware was purchased by Murdoch Children's Research Institute.