Systematic review and meta‐analysis of optimal initial fraction of oxygen levels in the delivery room at ≤32 weeks. (21st May 2014)

• Record Type: Journal Article
• Authors: Saugstad, Ola Didrik; Aune, Dagfinn; Aguar, Marta; Kapadia, Vishal; Finer, Neil; Vento, Maximo
• Is Part Of: Acta pædiatrica. Volume 103:Number 7(2014:Jul.)
• Page Start: 744
• Page End: 751
• Publication Date: 2014-05-21
• Subjects: Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.12656
• Languages: English
• ISSNs: 0803-5253

Abstract

<abstract abstract-type="main" id="apa12656-abs-0001"> <title>Abstract</title> <sec id="apa12656-sec-0001" sec-type="section"> <title>Aim</title> <p>The optimal initial fraction of oxygen (iFiO<sub>2</sub>) for resuscitating/stabilising premature infants is not known. We aimed to study currently available information and provide guidelines regarding the iFiO<sub>2</sub> levels needed to resuscitate/stabilise premature infants of ≤32 weeks' gestation.</p> </sec> <sec id="apa12656-sec-0002" sec-type="section"> <title>Methods</title> <p>Our systematic review and meta‐analysis studied the effects of low and high iFiO<sub>2</sub> during the resuscitation/stabilisation of 677 newborn babies ≤32 weeks' gestation.</p> </sec> <sec id="apa12656-sec-0003" sec-type="section"> <title>Results</title> <p>Ten randomised studies were identified covering 321 infants receiving low (0.21–0.30) iFiO<sub>2</sub> levels and 356 receiving high (0.60–1.0) levels. Relative risk for mortality was 0.62 (95% CI: 0.37–1.04, I<sup>2</sup> = 0%, p<sub>heterogeneity</sub> = 0.88) for low versus high iFiO<sub>2</sub> ; for bronchopulmonary dysplasia, it was 1.11 (95% CI: 0.73–1.68, I<sup>2</sup> = 46%, p<sub>heterogeneity</sub> = 0.06); and for intraventricular haemorrhage, it was 0.90 (95% CI: 0.53–1.53, I<sup>2</sup> = 9%, p<sub>heterogeneity</sub> = 0.36).</p> </sec> <sec id="apa12656-sec-0004" sec-type="section"> <title>Conclusion</title> <p>These data show that reduced mortality approached significance when a low iFiO<sub>2</sub> (0.21–0.30) was used for initial stabilisation, compared to a high iFiO<sub>2</sub> (0.60–1.0). There was no significant association for bronchopulmonary dysplasia or intraventricular haemorrhage when comparing low and high iFiO<sub>2</sub>. Based on present data, premature babies ≤32 weeks' gestation in need of stabilisation in the delivery room should be given an iFiO<sub>2</sub> of 0.21–0.30.</p> </sec> </abstract>