In this clinical trial the Investigators aimed to assess the Adrenomedullin (AM) release in
      urine and plasma in preterm infants undergoing Sustained Inflation or Positive Pressure
      Ventilation at birth to manage respiratory failure.

Adrenomedullin Changes After Sustained Inflation or Positive Pressure Ventilation at Birth

Lung Injury

Background and objectives: The respiratory management in the DR may play an important role in
      the development and prevention of lung injury. The sustained lung inflation (SI) is a
      promising approach to facilitate cardio-respiratory transition, but currently, although it
      has been shown to decrease the duration of MV, seems not to guarantee relevant benefits
      compared to Positive Pressure Ventilation (PPV). In order to clarify the impact of these two
      different approaches on lung tissues, this study measures Adrenomedullin (AM), which is a
      biomarker involved in lung development.

      Methods: we conducted a prospective case control-study in a cohort of very low birth weight
      (VLBW) infants (< 1500 g) of 28+0-30+6 weeks of gestational age (GA), who received SI or PPV
      during stabilization in DR.

      Exclusion criteria were major malformations (i.e. congenital heart disease, cerebral, lung
      and abdominal malformations), fetal hydrops, lack of parental consent and need for
      endotracheal intubation at birth.

      Blood samples for AM measurement were collected at birth from the arterial umbilical cord
      before resuscitation maneuvers, then at 1 hour from birth and at 24 hours from birth.
      Moreover, urine samples were collected, in correspondence with the first urine emission while
      in NICU and at 24 hours of life.

Sustained Inflation

Positive Pressure Ventilation

Effects of Sustained Inflation or Positive Pressure Ventilation on Release of Adrenomedullin in Preterm Infants With Respiratory Failure at Birth

to investigate, in a cohort of preterm infants with respiratory failure at birth, the short-term AM release (plasma and urine samples at different time-points) after initial resuscitation with SI or PPV.

Positive Pressure Ventilation ( peak pressure set at 25 cmH20 and PEEP set at 5 cmH2O, with 40 inflations per minute)

Prolonged inflation ( 25 cmH20 for 15 seconds) followed by PEEP set at 5 cmH2O

Adrenomedullin Changes After Sustained Inflation or Positive Pressure Ventilation at Birth

About this trial

Study ID

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Type

Phase

Placebo

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Not accepting

Trial Timing

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