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 <34+0 gestational weeks and need for respiratory support (RS) during postnatal transition were included. Within the first 15 min of life of each subject ΔcHb and cTOI were continuously detected by using ‘NIRO-200-NX’ (Hamamatsu; Japan).
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 ΔcHb 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.