title: Efficacy of FiO2 increase during the initial resuscitation of premature infants < 29 weeks: an observational study.
abstract: OBJECTIVE
  To evaluate the heart rate (HR) and oxygen saturation (SpO2) at 15-second intervals within 60 seconds after incremental increases of fractional inspired oxygen (FiO2) during resuscitation of infants younger than 29 weeks requiring two different forms of ventilatory support.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Forty-three infants were stabilized, 14 by continuous positive airway pressure exclusively (CPAP group), and 29 by positive pressure ventilation (PPV group). Both groups received ventilatory support in a special bed with two cameras enabling the evaluation of all interventions including HR, SpO2, FiO2, positive inflation pressure, and positive end-expiratory pressure values. FiO2 was commenced at 0.30 and titrated in 0.1-0.2 increments every 30-60 seconds. The relationships between the incremental increases of FiO2 and related SpO2 and HR changes were evaluated.
  
  
  RESULTS
  Although there was an inverse correlation between initial FiO2 and SpO2 in both groups, a significant positive correlation between the incremental increase of FiO2 and SpO2 changes after 30 seconds was found only in the CPAP group. Only higher initial levels of FiO2 had a positive effect on the improvement in SpO2 in the PPV group.
  
  
  CONCLUSIONS
  The efficacy of FiO2 titration in 0.1-0.2 increments may be attenuated and delayed in extremely preterm infants required PPV during the first 6 minutes of life.
authors.affiliation: Division of Neonatology, Department of Obstetrics and Gynecology, General Faculty Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Tereza
authors.initials: T
authors.lastname: Lamberska
authors.forename: Jana
authors.initials: J
authors.lastname: Vaňkova
authors.forename: Richard
authors.initials: R
authors.lastname: Plavka
mesh_terms: D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D010100:Oxygen / Q000032:analysis*; D011175:Positive-Pressure Respiration; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D010100:Oxygen
keywords: FiO(2) titration; delivery room; extremely premature infants; ventilatory support