Does sustained lung inflation at resuscitation reduce lung injury in the preterm infant?

Harling, A. E.; Beresford, M. W.; Vince, G. S.; Bates, M.; Yoxall, C. W.
September 2005
Archives of Disease in Childhood -- Fetal & Neonatal Edition;Sep2005, Vol. 90 Issue 5, pF406
Academic Journal
Background: Bronchopulmonary dysplasia (BPD) is a common outcome of preterm birth. Experimental animal work has shown that initial ventilation strategies injure the immature lung and may lead to BPD. Studies with asphyxiated babies have shown that, if tidal ventilation at birth is preceded by sustained lung inflation, larger inflation volumes can be achieved, which is thought to lead to clearance of lung fluid and formation of the functional residual capacity (FRC). Objective: To see if sustained lung inflation at initial resuscitation of preterm babies would facilitate the removal of lung fluid, establish the FRC, and allow an even distribution of alveolar opening, permitting less aggressive ventilation, leading to a reduction in pulmonary inflammation and subsequent BPD. Method: The outcomes of 52 babies of less than 31 weeks gestation, resuscitated at birth using either a sustained lung inflation of five seconds or a conventional lung inflation of two seconds for the first assisted breath of resuscitation, were examined. Evidence of pulmonary inflammation was determined by quantification of interleukins 6, 10, and 1 β and tumour necrosis factor α in bronchoalveolar lavage fluid by enzyme linked immunosorbent assay. Results: There were no significant differences in any of the cytokines. Death occurred in 3/26 babies in the conventional group and 6/26 babies in the sustained lung inflation group. Survival without BPD occurred in 13/26 and 14/26 respectively. Conclusion: The use of sustained lung inflation at resuscitation did not reduce lung injury, as measured by inflammatory markers.


Related Articles

  • Does the use of 50% oxygen at birth in preterm infants reduce lung injury? Harling, A. E.; Beresford, M. W.; Vince, G. S.; Bates, M.; Yoxall, C. W. // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Sep2005, Vol. 90 Issue 5, pF401 

    Background: Bronchopulmonary dysplasia is an inflammatory fibrotic condition produced as a consequence of injurious influences in the neonatal lung. Exposing the premature lung to high concentrations of oxygen is thought to play an important part in lung injury pathogenesis. Objective: To see if...

  • The development of inducible bronchus-associated lymphoid tissue depends on IL-17. Rangel-Moreno, Javier; Carragher, Damian M; de la Luz Garcia-Hernandez, Maria; Hwang, Ji Young; Kusser, Kim; Hartson, Louise; Kolls, Jay K; Khader, Shabaana A; Randall, Troy D // Nature Immunology;Jul2011, Vol. 12 Issue 7, p639 

    Ectopic or tertiary lymphoid tissues, such as inducible bronchus-associated lymphoid tissue (iBALT), form in nonlymphoid organs after local infection or inflammation. However, the initial events that promote this process remain unknown. Here we show that iBALT formed in mouse lungs as a...

  • RESUSCITATION OF THE NEWBORN. Weintraub, David H. // Clinical Pediatrics;Nov1964, Vol. 3 Issue 11, p660 

    Discusses the resuscitation of the lungs of the newborn and rapid oxygenization of the blood. Symptoms of severely depressed infant at birth; Medication of mothers before delivery of depressed infant; Results of the treatment of asphyxia of the newborn with hyperbaric oxygen.

  • Long-term Suppression of Experimental Arthritis Following Intramuscular Administration of a Pseudotyped AAV2/1-TNFR:Fc Vector. Sandalon, Ziv; Bruckheimer, Elizabeth M; Lustig, Kurt H.; Burstein, Haim // Molecular Therapy;Feb2007, Vol. 15 Issue 2, p264 

    We previously reported that administration of an adeno-associated virus 2 (AAV2) vector encoding a rat tumor necrosis factor (TNF) receptor–immunoglobulin Fc (TNFR:Fc) fusion gene to rats with streptococcal cell wall-induced arthritis resulted in suppression of joint inflammation and...

  • The role of tumor necrosis factor (TNF) in the febrile and metabolic responses of rats to intraperitoneal injection of a high dose of lipopolysaccharide. Töllner, Birgit; Roth, Joachim; Störr, Birgit; Martin, Dave; Voigt, Karlheinz; Zeisberger, Eugen // Pflugers Archiv European Journal of Physiology;Oct2000, Vol. 440 Issue 6, p925 

    Injection of a high dose of lipopolysaccharide (LPS) induces a septic-shock-like state, which can be accompanied by phases of hypothermia and phases of fever. In the present study we monitored body core temperature and locomotor activity, both by remote radiotelemetry, as well as changes in food...

  • Tumor Necrosis Factor-α-Induced Ototoxicity in Mouse Cochlear Organotypic Culture. Wu, Qian; Wang, Guo-Peng; Xie, Jing; Guo, Jing-Ying; Gong, Shu-Sheng // PLoS ONE;May2015, Vol. 10 Issue 5, p1 

    Tumor necrosis factor (TNF)-α is a cytokine involved in acute inflammatory phase reactions, and is the primary upstream mediator in the cochlear inflammatory response. Treatment of the organ of Corti with TNF-α can induce hair cell damage. However, the resulting morphological changes have...

  • An Unusual Cause of Heart Failure. Ziai, Mohsen; Preis, Karen // Clinical Pediatrics;May1975, Vol. 14 Issue 5, p515 

    The article presents a case of a newborn who became apneic immediately after birth. The child required resuscitation with positive pressure oxygen for five minutes. When first seen, the infant, though sleepy, was easily arousable, had a good strong cry, and showed no signs of postmaturity. The...

  • Respiratory monitoring of neonatal resuscitation. Schmölzer, Georg M.; Kamlin, Omar C. O. F.; Dawson, Jennifer A.; te Pas, Arjan B.; Morley, Colin J.; Davis, Peter G. // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Apr2010, Vol. 95 Issue 4, pF295 

    Video observations and recordings of respiratory signals from mannequin studies and delivery room (DR) resuscitations are described. This article discusses the uses of a respiratory function monitor (RFM) during training and resuscitations along with potential pitfalls and limitations. It adds...

  • Cytokine profile in elderly patients with sepsis. Kumar, Anil T.; Sudhir, U.; Punith, K.; Kumar, Rahul; Kumar, V. N. Ravi; Rao, Medha Y. // Indian Journal of Critical Care Medicine;Apr-Jun2009, Vol. 13 Issue 2, p74 

    Context: Sepsis is a serious health problem in the elderly with a high degree of mortality. There is very limited data available in elderly subjects regarding the markers for sepsis. Development of good markers will help in overall management and prediction of sepsis. Objectives: Serial...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics