title: Resuscitation of preterm infants with different inspired oxygen fractions.
abstract: OBJECTIVE
  To test the hypothesis that an initial fraction of inspired oxygen (FiO2) of 30% during resuscitation of preterm infants results in less oxidative stress and is associated with improved clinical outcomes compared with an FiO2 of 65%.
  
  
  METHODS
  Preterm infants of gestational age <32 weeks (n = 193) were randomized to start resuscitation with either 30% oxygen (low-oxygen group) or 65% oxygen (high-oxygen group), after which the FiO2 was adjusted based on oxygen saturation values. The primary outcome was bronchopulmonary dysplasia (BPD) assessed at 36 weeks postmenstrual age. Secondary outcomes included major neonatal illnesses and markers of oxidative stress.
  
  
  RESULTS
  The median gestational age of included infants was 28(6)/7 weeks (IQR, 26(5)/7-30(3)/7 weeks). The incidence of BPD was not significantly different between the low-oxygen and high-oxygen groups (24% vs. 17%; P = .15). The FiO2 in both groups was adjusted to a mean of 40% by 7 minutes in the low-oxygen group and by 11 minutes in the high-oxygen group. No differences in markers of oxidative stress were noted between groups.
  
  
  CONCLUSIONS
  Initial supplementation of preterm infants with 30% oxygen during the fetal-to-neonatal transition is as safe as 65% oxygen, with no differences in oxidative stress markers or BPD.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Denise
authors.initials: D
authors.lastname: Rook
authors.affiliation: Department of Pediatrics, Academic Medical Center-Emma Children's Hospital, Amsterdam, The Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: Schierbeek
authors.affiliation: Division of Neonatology, La Fe University and Polytechnic Hospital, Valencia, Spain; Neonatal Research Unit, La Fe Health Research Institute, Valencia, Spain.
authors.forename: Maximo
authors.initials: M
authors.lastname: Vento
authors.affiliation: Department of Pediatrics, Division of Neonatology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Hester
authors.initials: H
authors.lastname: Vlaardingerbroek
authors.affiliation: Department of Pediatrics, Division of Neonatology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Delft, The Netherlands.
authors.forename: Anne C
authors.initials: AC
authors.lastname: van der Eijk
authors.affiliation: Department of Pediatrics, Obstetrics, and Reproductive Medicine, University of Siena, Siena, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Longini
authors.affiliation: Department of Pediatrics, Obstetrics, and Reproductive Medicine, University of Siena, Siena, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Buonocore
authors.affiliation: Neonatal Research Unit, La Fe Health Research Institute, Valencia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Escobar
authors.affiliation: Department of Pediatrics, Academic Medical Center-Emma Children's Hospital, Amsterdam, The Netherlands; Department of Pediatrics, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: h.vangoudoever@amc.uva.nl.
authors.forename: Johannes B
authors.initials: JB
authors.lastname: van Goudoever
authors.affiliation: Department of Pediatrics, Division of Neonatology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Marijn J
authors.initials: MJ
authors.lastname: Vermeulen
mesh_terms: D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000379:methods; D008297:Male; D018384:Oxidative Stress / Q000502:physiology; D010100:Oxygen / Q000627:therapeutic use*; D010101:Oxygen Consumption / Q000502:physiology*; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012151:Resuscitation / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D010100:Oxygen