PMID- 24218465
OWN - NLM
STAT- MEDLINE
DCOM- 20140128
LR  - 20211021
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Print)
IS  - 0031-4005 (Linking)
VI  - 132
IP  - 6
DP  - 2013 Dec
TI  - Resuscitation of preterm neonates with limited versus high oxygen strategy.
PG  - e1488-96
LID - 10.1542/peds.2013-0978 [doi]
AB  - OBJECTIVE: To determine whether a limited oxygen strategy (LOX) versus a high 
      oxygen strategy (HOX) during delivery room resuscitation decreases oxidative 
      stress in preterm neonates. METHODS: A randomized trial of neonates of 24 to 34 
      weeks' gestational age (GA) who received resuscitation was performed. LOX 
      neonates received room air as the initial resuscitation gas, and fraction of 
      inspired oxygen (Fio2) was adjusted by 10% every 30 seconds to achieve target 
      preductal oxygen saturations (Spo2) as described by the 2010 Neonatal 
      Resuscitation Program guidelines. HOX neonates received 100% O2 as initial 
      resuscitation gas, and Fio2 was adjusted by 10% to keep preductal Spo2 at 85% to 
      94%. Total hydroperoxide (TH), biological antioxidant potential (BAP), and the 
      oxidative balance ratio (BAP/TH) were analyzed in cord blood and the first hour 
      of life. Secondary outcomes included delivery room interventions, respiratory 
      support on NICU admission, and short-term morbidities. RESULTS: Forty-four LOX 
      (GA: 30 +/- 3 weeks; birth weight: 1678 +/- 634 g) and 44 HOX (GA: 30 +/- 3 weeks; 
      birth weight: 1463 +/- 606 g) neonates were included. LOX decreased integrated 
      excess oxygen ( summation operatorFio2 x time [min]) in the delivery room compared with HOX (401 +/- 
      151 vs 662 +/- 249; P < .01). At 1 hour of life, BAP/TH was 60% higher for LOX 
      versus HOX neonates (13 [9-16] vs 8 [6-9]) microM/U.CARR, P < .01). LOX decreased 
      ventilator days (3 [0-64] vs 8 [0-96]; P < .05) and reduced the incidence of 
      bronchopulmonary dysplasia (7% vs 25%; P < .05). CONCLUSIONS: LOX is feasible and 
      results in less oxygen exposure, lower oxidative stress, and decreased 
      respiratory morbidities and thus is a reasonable alternative for resuscitation of 
      preterm neonates in the delivery room.
FAU - Kapadia, Vishal S
AU  - Kapadia VS
AD  - The University of Texas Southwestern Medical Center at Dallas, Department of 
      Pediatrics, Division of Neonatal-Perinatal Medicine, 5323 Harry Hines Blvd, 
      Dallas, TX 75390-9063. myra.wyckoff@utsouthwestern.edu.
FAU - Chalak, Lina F
AU  - Chalak LF
FAU - Sparks, John E
AU  - Sparks JE
FAU - Allen, James R
AU  - Allen JR
FAU - Savani, Rashmin C
AU  - Savani RC
FAU - Wyckoff, Myra H
AU  - Wyckoff MH
LA  - eng
SI  - ClinicalTrials.gov/NCT01697904
GR  - K23 HD069521/HD/NICHD NIH HHS/United States
GR  - UL1 TR000451/TR/NCATS NIH HHS/United States
GR  - UL1 TR001105/TR/NCATS NIH HHS/United States
GR  - UL1TR000451/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20131111
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
RN  - 0 (Antioxidants)
RN  - 0 (Biomarkers)
RN  - 0 (Free Radicals)
RN  - S88TT14065 (Oxygen)
SB  - IM
CIN - Pediatrics. 2013 Dec;132(6):e1661-3. PMID: 24218459
MH  - Antioxidants/metabolism
MH  - Biomarkers/blood
MH  - Female
MH  - Free Radicals/blood
MH  - Humans
MH  - Infant, Newborn
MH  - Infant, Premature/*blood
MH  - Infant, Premature, Diseases/epidemiology/etiology/prevention & control
MH  - Intensive Care, Neonatal/*methods
MH  - Linear Models
MH  - Male
MH  - Oxidative Stress
MH  - Oxygen/*blood
MH  - Oxygen Inhalation Therapy/adverse effects/*methods
MH  - Practice Guidelines as Topic
MH  - Prospective Studies
MH  - Respiration, Artificial/statistics & numerical data
MH  - Resuscitation/adverse effects/*methods
PMC - PMC3838529
OTO - NOTNLM
OT  - newborn
OT  - oxidative stress
OT  - oxygen
OT  - preterm
OT  - resuscitation
EDAT- 2013/11/13 06:00
MHDA- 2014/01/29 06:00
PMCR- 2014/12/01
CRDT- 2013/11/13 06:00
PHST- 2013/11/13 06:00 [entrez]
PHST- 2013/11/13 06:00 [pubmed]
PHST- 2014/01/29 06:00 [medline]
PHST- 2014/12/01 00:00 [pmc-release]
AID - peds.2013-0978 [pii]
AID - 10.1542/peds.2013-0978 [doi]
PST - ppublish
SO  - Pediatrics. 2013 Dec;132(6):e1488-96. doi: 10.1542/peds.2013-0978. Epub 2013 Nov 
      11.