Optimizing oxygen therapy for preterm infants at birth: Are we there yet?

Area of Science:

• Neonatal Medicine
• Pediatric Respiratory Care
• Perinatal Physiology

Background:

• Oxygen has been a cornerstone of respiratory support for preterm infants for over 200 years.
• Premature infants often require supplemental oxygen for successful transition due to lung immaturity.
• Excessive oxygen can lead to oxidative stress and tissue injury in neonates.

Purpose of the Study:

• To review the historical and physiological basis of oxygen therapy in the delivery room for preterm infants.
• To evaluate current literature on optimal oxygen administration during neonatal resuscitation.
• To identify practice points and knowledge gaps in current oxygen therapy protocols.

Main Methods:

• Literature review of historical and contemporary studies on oxygen therapy in preterm infants.
• Analysis of physiological responses to oxygen in the neonatal transition period.
• Synthesis of evidence to inform clinical practice and future research.

Main Results:

• Significant advancements in understanding oxygen's role have occurred over the past three decades.
• The precise optimal oxygen concentration for preterm infant resuscitation remains undetermined.
• Current practices vary, highlighting a need for evidence-based guidelines.

Conclusions:

• Optimizing oxygen therapy in the delivery room is critical for improving preterm infant outcomes.
• Further research is needed to establish evidence-based guidelines for neonatal resuscitation.
• Balancing the benefits of oxygen with the risks of hyperoxia is essential for preterm infant care.