title: Outcomes of preterm infants following the introduction of room air resuscitation.
abstract: BACKGROUND
  After 2006 most neonatal intensive care units (NICUs) in Canada stopped initiating newborn resuscitation with 100% oxygen.
  
  
  METHODS
  In this retrospective cohort study, we compared neonatal outcomes in infants born at ≤ 27 weeks gestation that received <100% oxygen (OXtitrate group, typically 21-40% oxygen) during delivery room resuscitation to infants that received 100% oxygen (OX100 group).
  
  
  RESULTS
  Data from 17 NICUs included 2326 infants, 1244 in the OXtitrate group and 1082 in the OX100 group. The adjusted odds ratio (AOR) for the primary outcome of severe neurologic injury or death was higher in the OXtitrate group compared with the OX100 group (AOR 1.36; 95% CI 1.11, 1.66). A similar increase was also noted when comparing infants initially resuscitated with room air to the OX100 group (AOR 1.33; 95% CI 1.04, 1.69). Infants in the OXtitrate group were less likely to have received either medical or surgical treatment for a patent ductus arteriosus (AOR 0.53; 95% CI 0.37, 0.74).
  
  
  CONCLUSIONS
  In Canadian NICUs, we observed a higher risk of severe neurologic injury or death among preterm infants of ≤ 27 weeks gestation following a change in practice to initiating resuscitation with either room air or an intermediate oxygen concentration.
authors.affiliation: Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada. Electronic address: jack.rabi@albertahealthservices.ca.
authors.forename: Yacov
authors.initials: Y
authors.lastname: Rabi
authors.affiliation: Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: abhay.lodha@albertahealthservices.ca.
authors.forename: Abhay
authors.initials: A
authors.lastname: Lodha
authors.affiliation: Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada. Electronic address: amuchou.soraisham@albertahealthservices.ca.
authors.forename: Amuchou
authors.initials: A
authors.lastname: Soraisham
authors.affiliation: Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada. Electronic address: nalini.singhal@albertahealthservices.ca.
authors.forename: Nalini
authors.initials: N
authors.lastname: Singhal
authors.affiliation: Sainte Justine University Health Centre, Montréal, Quebec, Canada. Electronic address: keith.barrington@mcgill.ca.
authors.forename: Keith
authors.initials: K
authors.lastname: Barrington
authors.affiliation: Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada. Electronic address: PShah@mtsinai.on.ca.
authors.forename: Prakesh S
authors.initials: PS
authors.lastname: Shah
mesh_terms: D000328:Adult; D000388:Air; D002170:Canada / Q000453:epidemiology; D003696:Delivery Rooms; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000628:therapy*; D007363:Intensive Care Units, Neonatal; D008297:Male; D016017:Odds Ratio; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies
keywords: Infant; Neonatal intensive care; Oxygen; Premature; Resuscitation