After birth, most infants require respiratory support to establish lung aeration. Continuous positive airway pressure and intermittent positive pressure ventilation are standard therapies, but their outcomes remain controversial. Initial sustained inflation is an alternative therapy that is being increasingly used. This study aims to compare the sustained inflation therapy with the standard therapies in infants requiring respiratory support.

This systematic review and meta-analysis consisted of 9 randomized clinical trials of preterm infants that compared sustained inflation with standard resuscitation. The primary objective of the study was mortality before hospital discharge.

The nine eligible studies included 1,406 infants, of which 736 were treated with sustained inflation and 670 with standard therapy. The death occurred in 85 infants (11.5%) who received sustained inflation and in 62 infants (9.3%) who received standard therapy. Further analysis suggested no difference in the primary outcome between subgroups based on the study design. The findings further indicated that sustained inflation was associated with an increased risk of death in the first 2 days after birth. The risk of adverse events was similar in the two groups.

The research concluded that there was no difference in death before hospital discharge among infants who underwent sustained inflation and standard therapy.