[Air or oxygen for neonatal resuscitation at birth?].
Most of the contemporary guidelines on newborn resuscitation are based on experience but lack scientific evidence. The use of 100% oxygen is one of the more evident. Today, these practices are questioned, particularly for the resuscitation of moderately depressed full-term or near-term newborns. Results of recent meta-analysis of trials that compared ventilation with room air versus pure oxygen at birth suggest current practices should be revisited. On the basis of these data, air can be the initial gas to use for these babies. Large-scale trials, including preterm and cause and/or severity of initial asphyxia, must now be undertaken before the publication of new guidelines for these populations.
Chabernaud
J-L
JL
SMUR pédiatrique (SAMU 92) et réanimation néonatale, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France. jean-louis.chabernaud@abc.aphp.fr
D000388:Air; D001238:Asphyxia Neonatorum / Q000401:mortality / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D018496:Hyperoxia / Q000150:complications / Q000209:etiology; D020925:Hypoxia-Ischemia, Brain / Q000401:mortality / Q000628:therapy; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000628:therapy*; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects / Q000295:instrumentation; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial / Q000009:adverse effects / Q000295:instrumentation; D012151:Resuscitation / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis