Related Experiment Video
Updated: Aug 18, 2026
Intratracheal Instillation of Stem Cells in Term Neonatal Rats
Published on: May 4, 2020
Does the use of 50% oxygen at birth in preterm infants reduce lung injury?
A E Harling1, M W Beresford, G S Vince
1NICU, Liverpool Women's Hospital, Liverpool L8 7SS, UK. Elizabeth.Harling@lwh-tr.nwest.nhs.uk
Insights
Reducing oxygen to 50% during neonatal resuscitation did not significantly alter outcomes for premature infants. This study found no increase in adverse clinical outcomes for babies receiving 100% oxygen, suggesting current practices may be safe.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Critical Care
Background:
- Bronchopulmonary dysplasia (BPD) is a fibrotic lung condition in neonates, often linked to oxygen exposure.
- Premature infants are particularly vulnerable to lung injury during resuscitation.
Purpose of the Study:
- To investigate if oxygen concentration during neonatal resuscitation impacts lung injury.
- To determine if reducing oxygen levels mitigates subsequent lung injury.
Main Methods:
- Compared outcomes of preterm infants (<31 weeks gestation) resuscitated with 50% vs. 100% oxygen.
- Measured pulmonary inflammation markers (cytokines IL-6, IL-1β, IL-10, TNF-α) in bronchoalveolar lavage fluid.
- Assessed clinical outcomes including mortality and BPD at 36 weeks postmenstrual age.
Main Results:
- No significant differences in measured cytokine levels between the 50% and 100% oxygen groups.
- Mortality rates were similar: 19% (100% oxygen) vs. 15% (50% oxygen).
- Survival without BPD was comparable: 54% (100% oxygen) vs. 50% (50% oxygen).
Conclusions:
- Resuscitation with 50% oxygen did not significantly improve short- or long-term outcomes compared to 100% oxygen.
- A small benefit from reduced oxygen cannot be entirely excluded.
- No increased adverse clinical outcomes were observed with 100% oxygen resuscitation.
Background:
Bronchopulmonary dysplasia is an inflammatory fibrotic condition produced as a consequence of injurious influences in the neonatal lung. Exposing the premature lung to high concentrations of oxygen is thought to play an important part in lung injury pathogenesis.
Objective:
To see if the amount of oxygen used during resuscitation at birth triggers events that lead to the subsequent lung injury and if a reduction in oxygen used leads to a reduction in lung injury.
Method:
The outcomes of newborn babies less than 31 weeks gestation who were resuscitated using either 50% or 100% oxygen were examined. Eight of the babies receiving 50% oxygen required an increase in their oxygen concentration. Evidence of pulmonary inflammation was determined by quantifying interleukin 6, 1beta, and 10 and tumour necrosis factor alpha in bronchoalveolar lavage fluid by enzyme linked immunosorbent assay.
Results:
There were no significant differences in any of the cytokines studied in either of the groups. Death occurred in 5/26 (19%) babies who received 100% oxygen and 4/26 (15%) babies who received 50% oxygen. Survival without bronchopulmonary dysplasia at 36 weeks postmenstrual age occurred in 14/26 (54%) and 13/26 (50%).
Conclusion:
Reducing the oxygen to 50% at resuscitation did not influence either short or long term outcomes, but a small benefit could not be excluded. There was no increase in adverse clinical outcomes in babies who received 100% oxygen.
Related Concept Videos
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue, improving...
01:27Oxygen Transport in the Blood
01:23Physiological Control of Respiration
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
01:29Oxygen Requirements and Growth Patterns