Study | Reason for exclusion |
---|---|
Bouziri 2011 | Not a clinical trial. Does not investigate sustained lung inflation |
Harling 2005 | Control group consisted of inflation for 2 seconds (5 seconds for intervention): As we defined sustained if > 1 second, this trial could not be included Infants in the SLI group were born more preterm and had lower median birth weight than those in the conventional group, although the P value was not provided. Median birth weight (range) was 885 (518 to 1460) grams in the SLI group and 1095 (560 to 1562) grams in the conventional group. Median gestational age (range) was 27 (23 to 30) weeks in the SLI group and 28 (23 to 31) weeks in the conventional group |
te Pas 2007 | This RCT enrolled newly born infants born at < 33 weeks of gestation free of known major congenital anomalies with respiratory distress Infants were randomised to inflation of 10 seconds at 20 cmH2O with a T‐piece via a nasal tube, or to intermittent PPV with a self‐inflating bag via a face mask. Infants randomised to the T‐piece received inflation for 10 seconds at 20 cmH2O followed by NCPAP at 5 to 6 cmH2O. If the infant's clinical response was unsatisfactory, another inflation of 10 seconds at 25 cmH2O and NIMV (PIP 20 to 25 cmH2O, inflation rate 60 per minute) could be given. If the infants' condition improved (satisfactory heart rate and colour) but they had irregular breathing, they could receive NIMV for several minutes. Infants who were judged to have inadequate breathing, remain bradycardic, or remain cyanosed in the delivery room after these interventions were intubated and mechanically ventilated. Infants randomised to the self‐inflating bag received initial inflations of 30 to 40 cmH2O, followed by inflations not > 20 cmH2O (inflation time was not specified or recorded) for 30 seconds. Infants judged to have inadequate breathing, remain bradycardic, or remain cyanosed in the delivery room after this intervention were intubated and mechanically ventilated. Infants in the sustained lung inflation group who were not intubated were transferred to the neonatal intensive care unit (NICU) on NCPAP at 5 to 6 cmH2O; non‐intubated infants in the control group were transferred to the NICU with supplemental oxygen and were monitored with pulse oximetry The intervention in this trial was multi‐faceted. In addition to a sustained inflation, many other aspects of respiratory care provided at birth differed between groups (ventilation device used; interface used; whether PEEP was used; whether NIMV was used; time allowed for stabilisation before intubation was considered; time of starting NCPAP). It is not possible to determine the relative contribution (if any) of each element of this intervention to differences in outcomes observed between groups |
NCPAP: nasal continuous positive airway pressure NICU: neonatal intensive care unit NIMV: nasal intermittent mandatory ventilation PEEP: positive end‐expiratory pressure PIP: peak inspiratory pressure PPV: positive pressure ventilation RCT: randomised controlled trial SLI: sustained lung inflation