Sustained lung inflation in extreme preterm infants

SUSTAINED LUNG INFLATION Preventing CPAP failure remains an elusive goal. Providing prophylactic sustained lung inflation (SLI) in the delivery room is one potential intervention that may prevent CPAP failure, and ultimately improve both pulmonary and neurodevelopmental outcomes in the highest-risk infants. Thus, the ability of prophylactic SLI to prevent the need for mechanical ventilation in the first 3 days of life in infants born at 25-28 weeks was evaluated. This trial showed that use of SLI reduced the need for mechanical ventilation in the first 72 hours of life. However, there was a higher, non-statistically significant increased incidence in pneumothorax in the group randomized to receive SLI. These data show that prophylactic SLI can decrease rates of CPAP failure, but larger studies are necessary to demonstrate safety and the effecton long-term outcomes.