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, 1beta, and 10 and tumour necrosis factor alpha 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.
RCT Entities:
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, 1beta, and 10 and tumour necrosis factor alpha 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.
Authors: Vishal Kapadia; Ju Lee Oei; Neil Finer; Wade Rich; Yacov Rabi; Ian M Wright; Denise Rook; Marijn J Vermeulen; William O Tarnow-Mordi; John P Smyth; Kei Lui; Steven Brown; Ola D Saugstad; Maximo Vento Journal: Resuscitation Date: 2021-08-20 Impact factor: 6.251
Authors: Vishal S Kapadia; Lina F Chalak; John E Sparks; James R Allen; Rashmin C Savani; Myra H Wyckoff Journal: Pediatrics Date: 2013-11-11 Impact factor: 7.124
Authors: Fernando C Barros; Zulfiqar Ahmed Bhutta; Maneesh Batra; Thomas N Hansen; Cesar G Victora; Craig E Rubens Journal: BMC Pregnancy Childbirth Date: 2010-02-23 Impact factor: 3.007
Authors: Kei Lui; Lisa J Jones; Jann P Foster; Peter G Davis; See Kwee Ching; Ju Lee Oei; David A Osborn Journal: Cochrane Database Syst Rev Date: 2018-05-04