Pressure-limited sustained inflation vs. gradual tidal inflations for resuscitation in preterm lambs
David G Tingay, Graeme R Polglase, Risha Bhatia, Clare A Berry, Robert J Kopotic, Clinton P Kopotic, Yong Song, Edgardo Szyld, Alan H Jobe, J Jane Pillow
JOURNAL OF APPLIED PHYSIOLOGY | AMER PHYSIOLOGICAL SOC | Published : 2015
Support of the mechanically complex preterm lung needs to facilitate aeration while avoiding ventilation heterogeneities: whether to achieve this gradually or quickly remains unclear. We compared the effect of gradual vs. constant tidal inflations and a pressure-limited sustained inflation (SI) at birth on gas exchange, lung mechanics, gravity-dependent lung volume distribution, and lung injury in 131-day gestation preterm lambs. Lambs were resuscitated with either 1) a 20-s, 40-cmH2O pressure-limited SI (PressSI), 2) a gradual increase in tidal volume (Vt) over 5-min from 3 ml/kg to 7 ml/kg (IncrVt), or 3) 7 ml/kg Vt from birth. All lambs were subsequently ventilated for 15 min with 7 ml/kg..View full abstract
Awarded by National Institute of Child Health and Human Development
Awarded by National Health and Medical Research Council of Australia (NHMRC) Fellowship
Awarded by EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
This research was supported by an unrestricted research grant from Fisher & Paykel Healthcare, the Women and Infants Research Foundation, National Institute of Child Health and Human Development 12714 (A. H. Jobe), and Fundasamin-Fundacion para la Salud Materno Infantil (E. Szyld). Investigator fellowship support was provided by a Sylvia and Charles Viertel Senior Medical Research Fellowship (J. J. Pillow), and a National Health and Medical Research Council of Australia (NHMRC) Fellowship (G. R. Polglase: 1026890; D. G. Tingay: 491286). Radiant warmer beds were provided by Fisher & Paykel Healthcare (Auckland, NZ). Essential blood-gas analysis equipment was accessed via an NHMRC Equipment Grant. Surfactant was donated by Chiesi Group (Chiesi Farmaceutici, Parma, Italy). D. G. Tingay and G. R. Polglase are supported by the Victorian Government Operational Infrastructure Support Program. J. J. Pillow's research program is supported by the Western Australia Government Medical and Health Research Infrastructure Fund.