Inflation times during resuscitation of preterm infants

Data on the effects of a prolonged inflation time during the resuscitation of very prematurely born infants are limited; one study showed no effect, and in another, although lower bronchopulmonary dysplasia (BPD) rates were seen, that effect could have been due to the prolonged inflation time, the positive end expiratory pressure applied or the combination of the two. The aims of our study were to assess the length of inflation times used during face mask and t-piece resuscitation of prematurely born infants in the labour suite and determine whether prolonged inflations led to longer inflation flow times. A respiration monitor (NM3 respiratory profile monitor) was used to record flow, airway pressure and tidal volume changes. The first five inflations for each baby were analysed. Forty prematurely born infants (median gestational age 30, range 26–32 weeks) were examined. Their median inflation pressure was 17.6 (range 12.2–27.4) cm H₂O, inflation time 0.89 (range 0.33–2.92) s, expiratory tidal volume 1.01 (range 0.02–11.41) ml/kg and inflation flow time 0.11 (range 0.04–0.54) s. There was no significant relationship between the inflation time and the inflation flow time, but there was a significant relationship between the inflation pressure and the inflation flow time (p = 0.024). Conclusion: These results suggest that prolonging inflation times during face mask resuscitation of prematurely born infants would not improve ventilation as prolonged inflation did not lead to longer inflation flow times.