Sustained Inflation for Delivery Room Resuscitation of Extremely Preterm Infants

At birth, the lung must fill with air and establish functional residual capacity (FRC) to take on its role as the organ of gas exchange. This process occurs quickly in healthy term infants, but surfactant deficiency and a compliant chest wall can prevent extremely preterm infants from achieving their FRC. Sustained inflation, a maneuver that delivers inflation pressure of 15–30 cm H₂O for up to 15 seconds to facilitate transition in this population, is widespread in many countries.

Investigators enrolled 426 extremely preterm infants at neonatal intensive care units in nine countries, including the U.S. Infants younger than 27 weeks with inadequate respiratory effort or bradycardia at birth were randomized to two sustained inflations at a pe…