The twists and turns of neonatal oxygen therapy

Although supplemental oxygen is one of the commonest treatments in neonatal medicine, the evidence base for deciding which newborns need it, and what is the appropriate dose remains weak. Clinical research in this area is difficult because it requires clinicians to depart from established practice and, in the case of oxygen therapy, the stakes seem far higher to them than for other investigational treatments. Consequently, beyond the knowledge that extreme hyperoxia and hypoxia are harmful, the middle ground remains uncertain for both preterm and term infants.