Background and Aims In neonatal resuscitation, the use of a sustained inflation (SI) after birth may facilitate lung recruitment. We aimed to assess the ability of several SIB to deliver a SI.

Method In a newborn preterm lamb, we compared 4 different SIB devices fitted with a PEEP valve against a T-piece, using a flow of 8 Lpm. Four operators aimed to give 3 targeted SI of 20 cmH₂O (displayed on a manometer) for 30 seconds. The study was repeated with the PEEP valve removed and again with no flow.

Results 204 combinations were analysed. Mean (SD) duration of SI, maximum inspiratory pressure (maximum IP) and average inspiratory pressure (average IP) are shown in the table.

PEEP valve removal and absence of flow made no significant difference to the SI time (P=0.34 and P=0.13 respectively), maximum IP (P=0.17 and P=0.12 respectively) or average IP (P=0.32 and P=0.60 respectively).

Conclusions SIB perform differently depending on the brand and some are able to deliver sustained SI even in the absence of gas flow. If medically indicated, this may be useful in a resource-limited setting with no gas supply.