Abstract

Background and aim Sustained lung inflations (SLI) promote lung aeration and alveolar recruitment. Changes in total haemoglobin (ΔcHb) and cerebral tissue oxygenation index (cTOI) measured by near-infrared spectroscopy (NIRS) give information on changes in cerebral blood volume (CBV) and regional oxygen saturation, respectively. Do SLI during resuscitation affect CBV and cTOI? Methods Preterm infants ≥28+0 and Two groups were compared based on RS: SLI group: RS was started by applying 1–2 SLI for 15sec at 25 cmH2O and continued by continuous positive airway pressure (CPAP) or positive pressure ventilation (PPV). Control group: CPAP/PPV depending on respiratory insufficiency. Results 40 preterm infants (23 female) with mean gestational age of 32+1 weeks (±3 days) and mean birth weight of 1707 g (±470) were included. Demographic data did not show significant differences between groups. Median Δ cHb was in SLI/control group -0.38/0.20 µM 30 sec after initializing RS, –1.33/–0.43 µM after 60 sec, 3.37/2.30 µM after 2 min, –0.19/–0.46 µM after 3 min, 2.52/1.05 µM after 5min and 2.93/–4.78 µM after 10 min. Median cTOI increased in SLI/control group from 49/47% 30 sec after initialising RS to 54/50% after 60 sec, to 56/51% after 2 min, to 56/58% after 3 min, to 61/61% after 5 min, and to 65/69% after 10 min. Conclusion Initialising RS immediately after birth by using SLI in preterm infants did not show significant differences in CBV and cTOI compared to control group.

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