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Does the use of 50% oxygen at birth in preterm infants reduce lung injury?
  1. A E Harling1,
  2. M W Beresford1,
  3. G S Vince2,
  4. M Bates2,
  5. C W Yoxall1
  1. 1NICU, Liverpool Women’s Hospital, Liverpool L8 7SS, UK
  2. 2Immunology Department, University of Liverpool, Liverpool L69 3GA
  1. Correspondence to:
    Miss Harling
    Neonatal Intensive Care Unit, Liverpool Women’s Hospital, Crown Street, Liverpool L8 7SS, UK;


Background: Bronchopulmonary dysplasia is an inflammatory fibrotic condition produced as a consequence of injurious influences in the neonatal lung. Exposing the premature lung to high concentrations of oxygen is thought to play an important part in lung injury pathogenesis.

Objective: To see if the amount of oxygen used during resuscitation at birth triggers events that lead to the subsequent lung injury and if a reduction in oxygen used leads to a reduction in lung injury.

Method: The outcomes of newborn babies less than 31 weeks gestation who were resuscitated using either 50% or 100% oxygen were examined. Eight of the babies receiving 50% oxygen required an increase in their oxygen concentration. Evidence of pulmonary inflammation was determined by quantifying interleukin 6, 1β, and 10 and tumour necrosis factor α in bronchoalveolar lavage fluid by enzyme linked immunosorbent assay.

Results: There were no significant differences in any of the cytokines studied in either of the groups. Death occurred in 5/26 (19%) babies who received 100% oxygen and 4/26 (15%) babies who received 50% oxygen. Survival without bronchopulmonary dysplasia at 36 weeks postmenstrual age occurred in 14/26 (54%) and 13/26 (50%).

Conclusion: Reducing the oxygen to 50% at resuscitation did not influence either short or long term outcomes, but a small benefit could not be excluded. There was no increase in adverse clinical outcomes in babies who received 100% oxygen.

  • BAL, bronchoalveolar lavage
  • BPD, bronchopulmonary dysplasia
  • IL, interleukin
  • PIP, peak inspiratory pressure
  • ROS, reactive oxygen species
  • TNFα, tumour necrosis factor α
  • bronchoalveolar lavage fluid
  • bronchopulmonary dysplasia
  • cytokines
  • oxygen

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  • Published Online First 29 April 2005

  • This research was supported by grants from The Smith & Nephew Foundation, The North West R&D Research Fellowship, and The Newborn Appeal.

  • Competing interests: none declared