***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND : Studies suggest that giving newly born preterm infants sustained lung inflation ( SLI ) may decrease their need for  mechanical ventilation ( MV ) and improve their respiratory outcomes . METHODS : We r and omly assigned infants born at 25 weeks 0 days to 28 weeks 6 days of gestation to receive SLI ( 25 cm H2O for 15 seconds ) followed by nasal continuous positive airway pressure ( nCPAP ) or nCPAP alone in the delivery room . SLI and nCPAP were delivered by using a neonatal mask and a T-piece ventilator . The primary end point was the need for MV in the first 72 hours of life . The secondary end points included the need for respiratory supports and survival without bronchopulmonary dysplasia ( BPD ) . RESULTS : A total of 148 infants were enrolled in the SLI group and 143 in the control group . Significantly fewer infants were ventilated in the first 72 hours of life in the SLI group ( 79 of 148 [ 53 % ] ) than in the control group ( 93 of 143 [ 65 % ] ) ; unadjusted odds ratio : 0.62 [ 95 % confidence interval : 0.38–0.99 ] ; P = .04 ) . The need for respiratory support and survival without BPD did not differ between the groups . Pneumothorax occurred in 1 % ( n = 2 ) of infants in the control group compared with 6 % ( n = 9 ) in the SLI group , with an unadjusted odds ratio of 4.57 ( 95 % confidence interval : 0.97–21.50 ; P = .06 ) . CONCLUSIONS : SLI followed by nCPAP in the delivery room decreased the need for MV in the first 72 hours of life in preterm infants at high risk of respiratory distress syndrome compared with nCPAP alone but did not decrease the need for respiratory support and the occurrence of BPD Background Current neonatal resuscitation guidelines recommend 3:1 compression : ventilation ( C : V ) ratio . Recently , animal studies reported that continuous chest compressions ( CC ) during a sustained inflation ( SI ) significantly improved return of spontaneous circulation ( ROSC ) . The approach of CC during SI ( CC+SI ) has not been examined in the delivery room during neonatal resuscitation . Hypothesis It is a feasibility study to compare CC+SI versus 3:1 C : V ratio during neonatal resuscitation in the delivery room . We hypothesised that during neonatal resuscitation , CC+SI will reduce the time to ROSC . Our aim was to examine if CC+SI reduces ROSC compared with 3:1 C : V CPR in preterm infants <33 weeks of gestation . Study design R and omised feasibility trial . Method Once CC was indicated all eligible infants were immediately and r and omly allocated to either CC+SI group or 3:1 C : V group . A sequentially numbered , brown , sealed envelope contained a folded card box with the treatment allocation was opened by the clinical team at the start of CC . Study interventions Infants in the CC+SI group received CC at a rate of 90/min during an SI with a duration of 20 s ( CC+SI ) . After 20 s , the SI was interrupted for 1 s and the next SI was started for another 20 s until ROSC . Infants in the ‘ 3:1 group ’ received CC using 3:1 C : V ratio until ROSC . Primary outcome Overall the mean ( SD ) time to ROSC was significantly shorter in the CC+SI group with 31 ( 9 ) s compared with 138 ( 72 ) s in the 3:1 C : V group ( p=0.011 ) . Conclusion CC+SI is feasible in the delivery room . Trial registration number Clinical trials.gov NCT02083705 , pre- results Abstract Aim : To evaluate efficacy and safety of delivery room ( DR ) sustained lung inflation ( SLI ) in resuscitation of preterm neonates . Methods : R and omized Controlled Trial including 112 preterm infants r and omized to either SLI ( n = 57 ) using T-piece resuscitator [ maximum three inflations with maximum pressure of 30 cmH2O for 15 s followed by continuous positive airway pressure ( CPAP ) of 5–7 cmH2O ] or conventional bag/mask inflation ( C BMI ) ( n = 55 ) using traditional self-inflating bag ( maximum pressure of 40 cmH2O at a rate of 40–60 per min ) . Failure was defined as the need for DR or first 72 h intubation . Cord and 2-h post-resuscitation blood sample s were collected to measure interleukin (IL)-1β and tumor necrosis factor-α levels before and after intervention . Results : SLI was associated with significantly higher success rate compared to C BMI [ 75.4 versus 54.5 % ; p = 0.017 ] , lower need for DR intubation [ 5.3 % versus 23.6 % ; ( X2 = 7.7 ; p = 0.005 ) ] , higher 5-min-Apgar score ( median 8 versus 7 ; p = 0.018 ) , shorter duration on nasal-CPAP ( p = 0.017 ) , and non-significantly different air leak ( 7 % versus 11 % ; p = 0.3 ) and bronchopulmonary dysplasia rates among survivors ( 2 % versus 11 % ; p = 0.09 ) . Post-resuscitation IL-1β plasma levels increased significantly in C BMI ( p = 0.009 ) and not in SLI group . Conclusion : Delivery room SLI is more effective than intermittent bag and mask inflation for improving short-term respiratory outcome  in preterm infants , without significant adverse effects AIM To compare the effects of sustained lung inflation ( SLI ) vs. st and ard resuscitation on physiologic responses of preterm infants during resuscitation . METHODS Preterm infants ( 25 - 32 weeks gestational age ) requiring positive-pressure ventilation or continuous positive airway pressure were r and omly assigned to either the SLI group ( SLI at 25cmH2O for 15s ) or Non-SLI group ( st and ard resuscitation alone ) . The heart rate ( HR ) , oxygen saturation ( SpO2 ) , oxygen requirement , and intubation rate in the delivery room were evaluated . RESULTS Eighty-one infants were enrolled ( SLI group , 43 ; Non-SLI group , 38 ) . The use of SLI effectively reduced the oxygen requirement . The mean fraction of inspired oxygen 10min after birth was 0.28 ( 95 % CI , 0.26 - 0.30 ) in the SLI group and 0.47 ( 95 % CI , 0.43 - 0.52 ) in the Non-SLI group ( p<0.001 ) . During the first 5min , infants in the SLI group trended towards a higher HR and SpO2 than those in the Non-SLI group . The intubation rate in the delivery room was not different between the two groups ; however , among infants ≤28 weeks gestational age , the intubation rate was lower in the SLI than Non-SLI group ( 5 of 17 [ 29 % ] vs. 10 of 16 [ 63 % ] , respectively ; p=0.05 ) . The duration of respiratory support , survival without bronchopulmonary dysplasia , and the occurrence of pneumothorax were not different between the groups . CONCLUSION SLI in infants who require respiratory support appears to be effective in facilitating postnatal transition as determined by HR and SpO2 responses , result ing in less oxygen supplementation . Further studies are needed to confirm the benefits of SLI Background : Sustained lung inflation ( SLI ) applied at birth has been demonstrated to lead to clearance of lung fluid and achievement of a precocious functional residual capacity in animal studies . Objectives : To verify if the application of SLI in preterm infants at birth may reduce the need for mechanical ventilation and improve their respiratory outcome . Methods : We prospect ively studied 89 infants with respiratory distress ( gestational age ( GA ) 28.1 ± 2.2 weeks ) treated at birth with a SLI ( 25 cm H2O , sustained for 15 s ) in addition to AAP recommendations versus a historical control group ( n = 119 ; GA 28.1 ± 2.0 weeks ) treated without SLI with the same device ( controlled positive end-expiratory pressure of 5 cm H2O ) . Results : The SLI group had less need for ( 51 vs. 76 % , p < 0.0001 ) and shorter duration of mechanical ventilation ( 5 ± 11 vs. 11 ± 19 days , p = 0.008 ) , a more frequent occurrence of exclusive nasal continuous airway pressure support ( 49 vs. 24 % , p < 0.0001 ) and INtubation-SURfactant-Extubation ( INSURE ) treatment ( 16 vs. 3 % , p = 0.01 ) , less need for surfactant ( 45 vs. 61 % , p = 0.027 ) and postnatal steroids ( 10 vs. 25 % , p = 0.01 ) , a shorter duration of oxygen therapy ( 21 ± 27 vs. 31 ± 31 days , p = 0.016 ) , and , finally , a lower occurrence of bronchopulmonary dysplasia in survivors ( 7 vs. 25 % , p = 0.004 ) . Multiple regression analysis showed that 23–27 weeks of GA and birth weight < 750 g increased the risk of mechanical ventilation , while a clinical risk index for babies ( CRIB ) score <3 as well as INSURE strategy and SLI treatment in the delivery room decreased it . Conclusions : The application of a SLI at birth in preterm infants with respiratory distress may decrease the need for mechanical ventilation without inducing evident adverse effects The protection of preterm lungs should start immediately after birth , and the current trial is a much awaited research in this direction . This study ( 1 ) evaluates the role of application of prophylactic sustained lung inflation ( SLI ) immediately after birth as a lung protective strategy in decreasing the need of  mechanical ventilation ( MV ) in first 72 hours of life and in preventing bronchopulmonary  dysplasia ( BPD ) among extreme preterm infants . BPD is a multifactorial disease , and the advantage of SLI over intermittent MV in terms of improving functional residual capacity ( 2,3 ) forms the basis of this trial . The application of SLI immediately after birth is a new strategy which was first evaluated by Lindner et al. in 1999 ( 4 ) . Two additional studies showed beneficial effects of SLI ; however , one was an observational study ( 5 ) and the other did not use positive end expiratory pressure ( 6 ) . The current r and omised trial has used nCPAP immediately after birth in the control group and in the intervention group following SLI , thus overcoming the disadvantage of the previous trial . The investigators eluci date d eligibility and exclusion criteria . The actual time of taking consent ( antenatal or immediately after birth ) is not clear . There was appropriate generation of the r and omisation sequence and allocation concealment . Although the research ers who decided to start MV and those assessing the study end points were blinded to the intervention however , the caregivers were not blinded which could have led to performance bias . Given the paucity of the literature , the amount and duration of pressure chosen for providing SLI seem appropriate . Authors have set the SpO2 targets at 88–95 % against the currently recommended targets of 91–95 % . The sample size was calculated a priori , and the outcomes were clearly defined . All r and omised subjects completed the trial as per protocol , and all predefined outcomes were reported . Authors have used intention-totreat principle . This study has shown that the application of prophylactic SLI followed by nCPAP in the delivery room decreased the need for MV in the first 72 hours of life in extreme preterm infants . However , there is no effect on the robust clinical outcomes such as death and /or BPD . Additionally , there is concern of a trend towards increased incidence of pneumothorax and interstitial emphysema , which may be related to the pressure and duration used in SLI . Moreover , there is no statistically significant difference in need and duration of any respiratory support . Although the trial has not result ed in reduction in BPD or death , the reduction in need of MV in first 72 hours may be beneficial in re source -restricted setting s where the availability of MV is limited . Given these findings , the routine application of SLI at birth can not be recommended in extreme preterm infants . More trials are required across different setting s and gestations to establish its efficacy . Given the risk of air leak syndromes , future trials also need to establish the optimal pressure and duration of SLI . Moreover , the data regarding the neurodevelopmental outcome need to be generated to establish its long-term safety Objective : To assess the need for respiratory support in late preterm infants treated with sustained lung inflation ( SLI ) at birth . Study design : In this controlled trial , we r and omly assigned infants born at 34 + 0 to 36 + 6 weeks of gestation to receive SLI ( 25 cmH2O for 15 s ) at birth , followed by continuous positive airway pressure ( CPAP ) or assistance according to the recommendations of the American Academy of Pediatrics . The primary outcome was the need for any type of respiratory support . The secondary outcomes included neonatal intensive care unit ( NICU ) admission for respiratory distress and length of stay . The risk ratios ( RRs ) and 95 % confidence intervals ( CIs ) of the outcomes were calculated for the SLI group in reference to the control 
    Output:
    
Sustained inflation was not better than intermittent ventilation for reducing mortality in the delivery room and during hospitalisation .
When considering secondary outcomes , such as need for intubation , need for or duration of respiratory support , or bronchopulmonary dysplasia , we found no evidence of relevant benefit for sustained inflation over intermittent ventilation .
The duration of mechanical ventilation was shortened in the SLI group .