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Survival and Neurodevelopmental Outcomes of Preterms Resuscitated With Different Oxygen Fractions

Nuria Boronat1, Marta Aguar1, Denise Rook2

  • 1Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain.

Pediatrics
|December 13, 2016
PubMed

Insights

The initial oxygen concentration (Fio2) used for stabilizing extremely preterm infants does not impact survival or neurodevelopmental outcomes at 24 months corrected age. Both low (0.3) and high (0.6-0.65) initial Fio2 levels showed similar results in this clinical trial.

Area of Science:

  • Neonatal Medicine
  • Pediatric Neurology
  • Clinical Trials

Background:

  • Stabilization of preterm infants often requires oxygen supplementation.
  • The optimal initial oxygen inspiratory fraction (Fio2) for preterm infant stabilization is debated.
  • This study addresses the impact of initial Fio2 on neurodevelopmental outcomes.

Purpose of the Study:

  • To compare neurodevelopmental outcomes at 24 months corrected age.
  • To evaluate infants randomly assigned to initial Fio2 of 0.3 versus 0.6-0.65.
  • To assess outcomes in extremely preterm infants.

Main Methods:

  • Randomized, controlled, double-blinded, multicenter international clinical trial.
  • Infants <32 weeks gestation assigned to initial Fio2 of 0.3 (Lowox) or 0.6-0.65 (Hiox).
  • Neurodevelopmental assessment using Bayley Scales of Infant and Toddler Development (Bayley-III) at 24 months.

Main Results:

  • 253 infants recruited, 206 completed follow-up; no differences in perinatal characteristics or neonatal morbidities.
  • No significant differences in mortality between groups at hospital discharge or follow-up completion.
  • No differences in Bayley-III scores, neurosensory handicaps, cerebral palsy, or language skills between groups.

Conclusions:

  • Initial lower (0.3) or higher (0.6-0.65) Fio2 during delivery room stabilization does not influence survival.
  • Neurodevelopmental outcomes at 24 months are not affected by the initial Fio2 used.
  • The choice of initial Fio2 for preterm infant stabilization has no long-term impact on key developmental milestones.
Abstract

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