Tataranno ML, Oei JL, Perrone S, et al. Acta Paediatr 2015
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, 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 isoprostanes (p=0.032) concentrations were significantly higher in the 100% oxygen group.
CONCLUSION: 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 isoprostanes levels between two and 12-hours-of-life. Correlations with clinical outcomes will be vital to optimise the use of oxygen in preterm resuscitation