Optimal Inspired Fraction of Oxygen in the Delivery Room for Preterm Infants

Area of Science:

• Neonatology
• Pediatric Respiratory Medicine
• Perinatal Care

Background:

• Preterm infants often experience respiratory system immaturity, posing significant challenges during postnatal adaptation.
• Positive pressure ventilation and oxygen are standard interventions in the delivery room to manage respiratory insufficiency.
• Current evidence on optimal oxygen management in neonates remains inconclusive regarding initial oxygen concentration, target saturation timelines, and titration strategies.

Purpose of the Study:

• To critically review and synthesize the latest scientific literature on oxygen management for preterm infants in the delivery room.
• To provide an updated understanding of the evidence surrounding optimal inspired oxygen fraction, oxygen saturation targets, and titration methods.
• To inform clinical practice and guide future research in neonatal respiratory support.

Main Methods:

• Systematic literature search of major biomedical databases.
• Critical appraisal of randomized controlled trials, observational studies, and meta-analyses.
• Synthesis of findings related to oxygen administration in the delivery room for preterm neonates.

Main Results:

• Evidence suggests variability in current oxygen administration practices.
• Specific oxygen saturation ranges and the timing to achieve them are debated.
• Optimal methods for oxygen titration based on infant response require further clarification.

Conclusions:

• There is a need for standardized guidelines on oxygen management for preterm infants in the delivery room.
• Further research is essential to determine the most effective strategies for initial oxygen concentration, achieving target saturations, and titration.
• Refining oxygen delivery protocols can potentially improve outcomes for vulnerable preterm newborns.