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Long term consequences of oxygen therapy in the neonatal period

Alan H Jobe1, Suhas G Kallapur

  • 1Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio 45229-3039, USA. alan.jobe@chmcc.org

Seminars in Fetal & Neonatal Medicine
|May 11, 2010
PubMed

Insights

Infants exposed to high oxygen levels may develop lung injury, but tolerance can be increased by factors like antenatal corticosteroids. Currently, no biomarkers predict individual infant oxygen injury risk.

Area of Science:

  • Neonatal physiology
  • Respiratory medicine
  • Developmental biology

Background:

  • Neonatal intensive care often involves prolonged high oxygen exposure.
  • This can lead to lung injury, such as bronchopulmonary dysplasia, in experimental models.
  • However, infants often tolerate oxygen exposure without severe injury, indicating complex regulatory mechanisms.

Purpose of the Study:

  • To explore factors influencing oxygen tolerance and injury in infants.
  • To understand how oxygen sensitivity is modulated by various conditions.
  • To identify potential biomarkers for predicting oxygen injury risk.

Main Methods:

  • Review of experimental models of oxygen exposure in animals.
  • Analysis of factors affecting oxygen tolerance (e.g., antenatal corticosteroids, inflammatory mediators, preconditioning).
  • Examination of factors increasing oxygen injury (e.g., intrauterine growth restriction, nutritional deficits).

Main Results:

  • High, prolonged oxygen exposure can delay alveolar septation and cause bronchopulmonary dysplasia phenotypes in experimental models.
  • Factors like antenatal corticosteroids and preconditioning can enhance tolerance to oxygen injury.
  • Intrauterine growth restriction and nutritional deficits exacerbate oxygen injury.
  • Infant sensitivity to oxygen injury appears variable, but predictive biomarkers are lacking.

Conclusions:

  • Oxygen exposure in neonates is a complex issue with variable outcomes.
  • Factors influencing tolerance and injury are multifaceted, involving developmental and environmental influences.
  • Development of biomarkers to predict individual oxygen injury risk is a critical unmet need.

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