Resuscitation of preterm newborns with low concentration oxygen versus high concentration oxygen

It is well known that a brief exposure to 100% oxygen for only a few minutes could be toxic for a preterm infant. The effectiveness of neonatal resuscitation was compared with low concentration oxygen (30%) and high concentration oxygen (HOG) (100%).

Thirty-two preterm neonates were born in Isfahan Shahid Beheshti hospital with gestational age of 29-34 weeks who required resuscitation were randomized into two groups. The resuscitation was begun with 30% O2 in low concentration oxygen group (LOG). The infants were examined every 60-90 seconds and if their HR was less than 100, 10% was added to the previous FIO2(fraction of inspired oxygen) until the HR increased to 100 and SO2(saturation of oxygen) increased to 85%. In HOG resuscitation begun with 100% O2 and every 60-90 seconds, FIO2 was decreased 10 - 15% until the HR reached to 100 and SO2 reached to 85%.

The FIO2 in LOG was increased stepwise to 45% and in HOG was reduced to 42.1% to reach stable oxygen saturation more than 85% at the fifth minute in both groups. At the first and third minutes after birth and there was no significant differences between groups in heart rate and after 1,2,4 and 5 minutes after the birth there was also no significant differences in SO2 between groups, regardless of the initial FIO2.

We can safely initiate resuscitation of preterm infants with a low FIO2(approximately 30%) oxygen and then oxygen should be adjusted with the neonates needs.