Effect of sustained inflations applied directly after cord clamping on lung function in premature newborn lambs.

We studied the possibility of improving lung volume and therefore clinical outcome in premature newborn lambs by increasing the inspiratory volumes during the first minute after birth. Sixteen lambs from eight were delivered by hysterotomy after 130-131 days' gestation. In eight lambs the lungs were inflated with a bag with a sustained inspiratory inflation (SI) of 5 s and expiratory time of 5 s during the first four inflations after cord clamping and then mechanically ventilated. Their siblings did not receive SI and served as a control group. At 8 h postnatally, the SI and control groups showed the following results (mean +/- SEM): mean airway pressure 14.8 +/- 1.8 cmH2O versus 11.9 +/- 1.1 cmH2O, PaO2 41.5 +/- 7.3 kPa versus 31.3 +/- 7.7 kPa, alveolar-arterial oxygen gradient 359 +/- 55 mmHg versus 437 +/- 58 mmHg. Clinical course, incidence of pneumothorax, oxygenation index, total static compliance, parenchymal-alveolar air area ratio or mortality rate were not different. There was no significant difference between the two groups at this time or at any other time during the experiments.