Resuscitation of newborn infants with 100% oxygen or air: a systematic review and meta-analysis

@article{Davis2004ResuscitationON,
  title={Resuscitation of newborn infants with 100\% oxygen or air: a systematic review and meta-analysis},
  author={Peter Graham Davis and Anton Tan and Colm P. F. O’Donnell and Andreas Schulze},
  journal={The Lancet},
  year={2004},
  volume={364},
  pages={1329-1333}
}
Resuscitation of Newborn Infants with 21% or 100% Oxygen: An Updated Systematic Review and Meta-Analysis
TLDR
There is a significant reduction in the risk of neonatal mortality and a trend towards a reduction inThe risk of severe hypoxic ischemic encephalopathy in newborns resuscitated with 21% O2.
Air versus oxygen for resuscitation of infants at birth.
TLDR
There is insufficient evidence at present on which to recommend a policy of using room air over 100% oxygen, or vice versa, for newborn resuscitation, and the small number of identified studies and their methodologic limitations dictate caution in interpreting and applying these results.
Resuscitation of Preterm Neonates by Using Room Air or 100% Oxygen
TLDR
Resuscitation with room air failed to achieve the authors' target oxygen saturation by 3 minutes of life, and it is recommended that it not be used for preterm neonates.
Air or 100% oxygen for asphyxiated babies? Time to decide
TLDR
Key areas include defining the best resuscitation practice for the preterm infant, designing adequate multicentre, randomised and blinded studies of term newborn resuscitation with adequate outcome data, and pursuing intense experimental research into the mechanisms and prevention of injury from oxygen free radicals.
A Review of Oxygen Use During Chest Compressions in Newborns—A Meta-Analysis of Animal Data
TLDR
Air had similar time to ROSC and mortality as 100% oxygen during neonatal chest compression and a large randomized controlled clinical trial comparing air vs. 100% Oxygen during chest compression is warranted.
Use of 100% Oxygen or Room Air in Neonatal Resuscitation
TLDR
Most international consensus guidelines recommend that if assisted ventilation is needed at birth, 100% oxygen should be delivered by positive pressure ventilation, but review of the literature suggests that these recommendations are more a result of precedent than based on sound evidence.
Room Air Resuscitation Versus Oxygen Resuscitation in the Delivery Room
TLDR
The question for perinatal medical and nursing personnel involved in newborn resuscitation in the delivery room is whether the use of RA reduces the possible adverse effects of 100% oxygen, including delay in short-term stabilization, death, neurological disability, and possible secondary oxygen free radical injury.
Consequences of neonatal resuscitation with supplemental oxygen.
TLDR
The rat pup model is developed and confirmed that hyperoxic resuscitation of rat pups is associated with a significant delay in onset of spontaneous respiratory efforts, and that supplementary oxygen can be reserved for non-responders.
...
...

References

SHOWING 1-10 OF 24 REFERENCES
Resuscitation of asphyxiated newborns with room air or 100% oxygen at birth: a multicentric clinical trial.
TLDR
Room air appears as good as 100% oxygen for resuscitation of asphyxic newborn babies at birth, and the two treatment groups were comparable for maternal, intrapartum and neonatal characteristics.
Resuscitation of newborn infants with 21% or 100% oxygen: follow-up at 18 to 24 months.
TLDR
There were no significant differences in somatic growth or neurologic handicap at an age of 18 to 24 months in infants resuscitated with either 21% or 100% O2 at birth, and resuscitation with ambient air seems to be safe, at least in most cases.
Resuscitation of Asphyxiated Newborn Infants With Room Air or Oxygen: An International Controlled Trial: The Resair 2 Study
TLDR
It is hypothesized that room air is superior to 100% oxygen when asphyxiated newborn infants are resuscitated, and a series of animal studies as well as one pilot study indicating that resuscitation can be performed with room air just as efficiently as with100% oxygen are performed.
Resuscitation at birth
  • A. Milner
  • Medicine
    European Journal of Pediatrics
  • 1998
TLDR
Although the pattern of ventilatory support in current use often leads to successful resuscitation of asphyxiated babies at birth, more physiological and randomised controlled studies are needed to refine techniques in order to limit babies' exposure to potentially damaging hypoxia to the minimum.
Resuscitation With Room Air Instead of 100% Oxygen Prevents Oxidative Stress in Moderately Asphyxiated Term Neonates
TLDR
There are no apparent clinical disadvantages in using room air for ventilation of asphyxiated neonates rather than 100% oxygen, and RAR infants recover more quickly as assessed by Apgar scores, time to the first cry, and the sustained pattern of respiration.
Resuscitation of Asphyxic Newborn Infants with Room Air or 100% Oxygen
TLDR
This preliminary study did not provide conclusive evidence that roomAir is superior to 100% oxygen in the resuscitation of asphyxiated newborns, although it indicated that room air is as effective as 100%oxy.
International Guidelines for Neonatal Resuscitation: An excerpt from the Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science. Contributors and Reviewers for the Neonatal Resuscitation Guidelines.
The International Guidelines 2000 Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC) formulated new evidenced-based recommendations for neonatal resuscitation. These
Six Years of Experience with the Use of Room Air for the Resuscitation of Asphyxiated Newly Born Term Infants
TLDR
Significant oxidative stress was found in the OxR group at 28 days of postnatal life when compared with normal control infants and the RAR group, and oxygen concentrations used during the resuscitation of newly born infants should be strictly monitored.
Oxygen at birth and prolonged cerebral vasoconstriction in preterm infants.
TLDR
Differences in oxygen exposure seemed to be the only explanation for the differences in CBF, which was significantly higher in group I than in group II.
Pulse oximetry, severe retinopathy, and outcome at one year in babies of less than 28 weeks gestation
TLDR
The lowest incidence of retinopathy in the study was associated with a policy that made little use of arterial lines, and attempts to keep oxygen saturation at a normal “physiological” level may do more harm than good in babies of less than 28 weeks gestation.
...
...