Yacov Rabi1, Doreen Rabi, Wendy Yee. 1. Department of Medicine, University of Calgary, Partnership for Research and Education in Mothers and Infants (PREMI) Institute, Calgary Health Region, Calgary, Alberta, Canada. jack.rabi@calgaryhealthregion.ca
Abstract
UNLABELLED: Understanding of the potential dangers of hyperoxia in the newborn is growing. Several studies have examined the use of room air for the resuscitation of newborns. OBJECTIVE: To assess the effects of room air resuscitation versus 100% oxygen resuscitation on mortality at 1 week and 1 month in asphyxiated newborn infants. STUDY DESIGN: Systematic review and meta-analysis of seven randomized and quasi-randomised controlled trials comparing room air and 100% oxygen resuscitation of newborn infants. RESULTS: Compared to the 100% oxygen resuscitation group, neonates in the room air resuscitation group had a lower mortality both in the first week of life (odds ratio 0.70, 95% CI 0.50, 0.98) and at 1 month and beyond (odds ratio 0.63, 95% CI 0.42, 0.94). The incidence of severe hypoxic ischemic encephalopathy (Stage II and Stage III) was similar between the two groups. CONCLUSION: This meta-analysis supports the hypothesis that room air is superior to 100% oxygen as the initial choice for resuscitating clinically depressed newborns as it may result in a lower mortality rate. However, adequately powered studies of long-term neurodevelopmental outcomes are not yet available.
UNLABELLED: Understanding of the potential dangers of hyperoxia in the newborn is growing. Several studies have examined the use of room air for the resuscitation of newborns. OBJECTIVE: To assess the effects of room air resuscitation versus 100% oxygen resuscitation on mortality at 1 week and 1 month in asphyxiated newborn infants. STUDY DESIGN: Systematic review and meta-analysis of seven randomized and quasi-randomised controlled trials comparing room air and 100% oxygen resuscitation of newborn infants. RESULTS: Compared to the 100% oxygen resuscitation group, neonates in the room air resuscitation group had a lower mortality both in the first week of life (odds ratio 0.70, 95% CI 0.50, 0.98) and at 1 month and beyond (odds ratio 0.63, 95% CI 0.42, 0.94). The incidence of severe hypoxic ischemicencephalopathy (Stage II and Stage III) was similar between the two groups. CONCLUSION: This meta-analysis supports the hypothesis that room air is superior to 100% oxygen as the initial choice for resuscitating clinically depressed newborns as it may result in a lower mortality rate. However, adequately powered studies of long-term neurodevelopmental outcomes are not yet available.
Authors: Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman Journal: Circulation Date: 2010-10-19 Impact factor: 29.690
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