Preterm Resuscitation With Low Oxygen Causes Less Oxidative Stress, Inflammation, and Chronic Lung Disease

Abstract

Resuscitation of preterm neonates with 30% oxygen causes less oxidative stress, inflammation, need for oxygen, and risk of bronchopulmonary dysplasia.

Transcriptome profiling of the newborn mouse lung after hypoxia and reoxygenation: hyperoxic reoxygenation affects mTOR signaling pathway, DNA repair, and JNK-pathway regulation

“…Current revised neonatal resuscitation guidelines recommend starting resuscitation with air for the term and near-term infant, but there is still no consensus on which FiO 2 to administer to the preterm (10). Recent data (11) indicate lower oxidative stress and long-term lung injury after resuscitation of preterm born babies with 30 vs. 90% oxygen.…”

Delivery room resuscitation of preterm infants in Canada: current practice and views of neonatologists at level III centers

“…Close to one third of responders start resuscitation with a delivered oxygen concentration of 30 to 50%, a practice that is supported by some recent small randomized controlled trials despite the fact these trials were not sufficiently powered to evaluate the impact on long-term outcome. [19][20][21][22] There is likely to be clinical equipoise until new evidence is provided or the recommendation is further modified. It is worth noting that 10% of respondents still use 100% oxygen to initiate resuscitation, which may induce hyperoxia and oxidative stress-mediated end-organ damage.…”

Learning to live with patency of the ductus arteriosus in preterm infants

“…Oxygen restriction immediately after birth does not predispose to subsequent persistence of PDA. 58 A recent retrospective analysis suggested that lower target saturation ranges increased the prevalence of early hemodynamically significant PDA, but not the ultimate closure rate or need for surgical ligations. 59 No differences in PDA or medical or surgical treatment for PDA were observed in a randomized trial comparing target ranges of oxygen saturation of 85 to 89% or 91 to 95% in preterm infants between 24 and 27 weeks' gestation.…”