title: Resuscitating preterm infants with 100% oxygen is associated with higher oxidative stress than room air.
abstract: OBJECTIVE
  The starting fraction of inspired oxygen for preterm resuscitation is a matter of debate, and the use of room air in full-term asphyxiated infants reduces oxidative stress. This study compared oxidative stress in preterm infants randomised for resuscitation with either 100% oxygen or room air titrated to internationally recommended levels of preductal oxygen saturations.
  
  
  METHODS
  Blood was collected at birth, two and 12 hours of age from 119 infants <32 weeks of gestation randomised to resuscitation with either 100% oxygen (n = 60) or room air (n = 59). Oxidative stress markers, including advanced oxidative protein products (AOPP) and isoprostanes (IsoP), were measured with high-performance liquid chromatography and mass spectrometry.
  
  
  RESULTS
  Significantly higher levels of AOPP were found at 12 hours in the 100% oxygen group (p < 0.05). Increases between two- and 12-hour AOPP (p = 0.004) and IsoP (p = 0.032) concentrations were significantly higher in the 100% oxygen group.
  
  
  CONCLUSIONS
  Initial resuscitation with room air versus 100% oxygen was associated with lower protein oxidation at 12 hour and a lower magnitude of increase in AOPP and IsoP levels between two and 12 hours of life. Correlations with clinical outcomes will be vital to optimise the use of oxygen in preterm resuscitation.
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: Tataranno
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.|Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia.
authors.forename: J L
authors.initials: JL
authors.lastname: Oei
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Perrone
authors.affiliation: School of Paediatrics, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: I M
authors.initials: IM
authors.lastname: Wright
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.|Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia.
authors.forename: J P
authors.initials: JP
authors.lastname: Smyth
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.|Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Lui
authors.affiliation: Australia Westmead International Network for Neonatal Education and Research, The University of Sydney, Camperdown, NSW, Australia.
authors.forename: W O
authors.initials: WO
authors.lastname: Tarnow-Mordi
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Longini
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Proietti
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Negro
authors.affiliation: Department of Pediatric Research, Oslo University Hospital, University of Oslo, Oslo, Norway.
authors.forename: O D
authors.initials: OD
authors.lastname: Saugstad
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Buonocore
mesh_terms: D000388:Air; D001238:Asphyxia Neonatorum / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D018384:Oxidative Stress; D010100:Oxygen / Q000008:administration & dosage*; D012151:Resuscitation / Q000379:methods*; D016037:Single-Blind Method
chemical_list: D010100:Oxygen
keywords: Free radicals; Oxidative stress; Preterm resuscitation; Protein and lipid oxidation; Targeted oxygen delivery