Sustained Inflation of Infant Lungs: From Bench to Bedside and Back Again

Cesarean delivery is common and is well known to result in a greater amount of residual lung fluid. [...]subsequent tidal breathing, both spontaneous and delivered by positive pressure ventilation, may occur in lungs that are only partially aerated, causing volutrauma even with a normal physiologic Vt. The strengths of this study include the thoroughly worked-out approach to exploring regional volume-related lung injury patterns, the seasoned investigative team, management that closely mimics clinical reality (antenatal steroids and postnatal surfactant), adequate statistical power, and comprehensive assessment of the distribution of ventilation, lung mechanics, and a variety of measures of lung injury. [...]the authors did not evaluate possible effects of this maneuver on cardiac output, pulmonary blood flow, or cerebral hemodynamics—issues of obvious relevance in future clinical trials.