AI Article Synopsis
- This study investigated the impact of scheduled lung recruitment maneuvers (LRMs) versus only when needed on extremely preterm infants undergoing high-frequency oscillatory ventilation (HFOV).* -
- In a randomized controlled trial with 30 infants (15 in each group), results showed no significant difference in the cumulative oxygen saturation index (OSI) or frequency of LRMs between both groups over a week.* -
- The findings suggest that performing LRMs regularly doesn't enhance lung volume compared to clinically indicated maneuvers, with most benefit seen when oxygen levels (FiO2) are high.*
Article Abstract
Background: Lung recruitment maneuvers (LRMs) improve lung volume at initiation of high-frequency oscillatory ventilation (HFOV), but it is unclear when to repeat LRMs. We evaluated the efficiency of scheduled LRMs.
Methods: In a randomized controlled trial, extremely preterm infants on HFOV received either LRMs at 12-hour intervals and when clinically indicated (intervention) or only when clinically indicated (control). The primary outcome was the cumulative oxygen saturation index (OSI) over HFOV time, limited to 7 days. Additionally, LRMs were analyzed with respect to OSI improvement.
Results: Fifteen infants were included in each group. The mean (SD) postmenstrual age and weight at HFOV start were 23 + 6 (0 + 5) weeks and 650 (115) g in the intervention group and 24 + 4 (0 + 6) weeks (p = 0.03) and 615 (95) g (p = 0.38) in the control group. The mean (SD) cumulative OSI amounted to 4.95 (1.72) in the intervention versus 5.30 (2.08) in the control group (p = 0.61). The mean (SD) number of LRMs in 12 h was 1.3 (0.2) in the intervention versus 1.1 (0.5) in the control group (p = 0.13). Performing LRM when FiO2 > 0.6 resulted in a mean OSI reduction of 3.6.
Conclusion: Regular versus clinically indicated LRMs were performed with equal frequency in preterm infants during HFOV, and consequently, no difference in lung volume was observed. LRMs seem to be most efficient at high FiO2.
Trial Registration: ClinicalTrials.gov ID: NCT04289324 (28/02/2020).
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9743585 | PMC |
| http://dx.doi.org/10.1186/s12887-022-03780-7 | DOI Listing |
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