Resuscitation of preterm newborns with low concentration oxygen versus high concentration oxygen

OBJECTIVE: It is well known that a brief exposure to 100% oxygen for only a few minutes could be toxic for a preterm infant. The effectiveness of neonatal resuscitation was compared with low concentration oxygen (30%) and high concentration oxygen (HOG) (100%). METHODS: Thirty-two preterm neonates were born in Isfahan Shahid Beheshti hospital with gestational age of 29-34 weeks who required resuscitation were randomized into two groups. The resuscitation was begun with 30% O(2) in low concentration oxygen group (LOG). The infants were examined every 60-90 seconds and if their HR was less than 100, 10% was added to the previous FIO(2)(fraction of inspired oxygen) until the HR increased to 100 and SO(2)(saturation of oxygen) increased to 85%. In HOG resuscitation begun with 100% O(2) and every 60-90 seconds, FIO(2) was decreased 10 – 15% until the HR reached to 100 and SO(2) reached to 85%. FINDINGS: The FIO(2) in LOG was increased stepwise to 45% and in HOG was reduced to 42.1% to reach stable oxygen saturation more than 85% at the fifth minute in both groups. At the first and third minutes after birth and there was no significant differences between groups in heart rate and after 1,2,4 and 5 minutes after the birth there was also no significant differences in SO(2) between groups, regardless of the initial FIO(2). CONCLUSION: We can safely initiate resuscitation of preterm infants with a low FIO(2)(approximately 30%) oxygen and then oxygen should be adjusted with the neonates needs.