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Oxygen saturation and heart rate during delivery room resuscitation of infants <30 weeks gestation with air or 100% oxygen.
  1. Jennifer A Dawson (jennifer.dawson{at}thewomens.org.au)
  1. The Royal Women's Hospital, Melbourne
    1. C. Omar Farouk Kamlin (omar.kamlin{at}rwh.org.au)
    1. The Royal Women's Hospital, Melbourne
      1. Connie Wong (connie.wong{at}rwh.org.au)
      1. The Royal Women's Hospital, Melbourne
        1. Arjan te Pas (arjan.tepas{at}rwh.org.au)
        1. The Royal Women's Hospital, Melbourne
          1. Colm Patrick Finbarr O'Donnell (codonnell{at}nmh.ie)
          1. National Maternity Hospital, Dublin
            1. Susan M Donath (susan.donath{at}mcri.edu.au)
            1. Murcoch Children's Research Institute
              1. Peter Graham Davis (pgd{at}unimelb.edu.au)
              1. The Royal Women's Hospital, Melbourne
                1. Colin J Morley (colin.morley{at}rwh.org.au)
                1. The Royal Women's Hospital, Melbourne

                  Abstract

                  Following concerns about harmful effects of 100% oxygen on newly born infants, we started resuscitation in the delivery room (DR) with air.

                  Objective: To describe preductal oxygen saturation (SpO2) and heart rate (HR) changes in the first 10 min after birth in very preterm infants initially resuscitated with 100% oxygen (OX100) or air (OX21).

                  Patients and Methods: In July 2006, our DR policy changed from using 100% oxygen to air. We report our observations of SpO2 and HR before and after the change when a member of the research team was available to attend the birth.

                  Results: We studied 20 infants initially resuscitated with 100% oxygen and 106 with air. In the OX100 group SpO2 rose to a median of 84% at two min and 94% by five min. In the OX21 group, median SpO2 was 31% at two min and 54% at five min. In the OX21 group 92% received supplementary oxygen at a median of 5 min; the SpO2 rose to a median of 81% by 6 min.

                  In the first 10 min after birth 80% and 55% of infants in the OX100 and OX21 groups respectively, had an SpO2 ≥ 95%. Increases in HR over the first 10 min were very similar in both groups.

                  Conclusions: Most very preterm infants received supplemental oxygen if the initial resuscitation used air. In these infants, the use of backup 100% oxygen and titration against SpO2 resulted in a similar course to “normal” term and preterm infants. Of the infants resuscitated with 100% oxygen, 80% had SpO2 ≥ 95% during the first 10 min. The heart rate changes in the two groups were very similar.

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