Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Initiating preterm resuscitation with less than 100% oxygen

Journal of Perinatology volume 30, page 366 (2010)Cite this article

Subjects

We thank Stola et al.1 for their study regarding the use of <100% FiO2 in preterm neonates during resuscitation. In accordance with the latest Neonatal Resuscitation Program (NRP) recommendations, an approach that includes starting with <100% oxygen for resuscitation has the potential to reduce oxygen toxicity. However, the report by Stola et al. of their own institutional experience raises some questions and concerns, which we would like to briefly summarize.

First, the authors note that in 47% of cases, FiO2 needed to be increased. It would have been more informative if the initial FiO2, as well as the final FiO2 at the end of resuscitation, had also been reported. This would allow us to determine whether the FiO2 was increased primarily in the resuscitations that began with lower initial FiO2. This could help guide us toward a reasonable starting point.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Stola A, Schulman J, Perlman J . Initiating delivery room stabilization/resuscitation in very low birth weight (VLBW) infants with an FiO2 less than 100% is feasible. J Perinatol 2009; 29: 548–552.

    Article  CAS  Google Scholar 

  2. Toth B, Becker A, Seelbach-Gobel B . Oxygen saturation in healthy newborn infants immediately after birth measured by pulse oximetry. Arch Gynecol Obstet 2002; 266: 105–107.

    Article  CAS  Google Scholar 

  3. Mariani G, Dik PB, Ezquer A, Aguirre A, Esteban ML, Perez C et al. Pre-ductal and post-ductal O2 saturation in healthy term neonates after birth. J Pediatr 2007; 150 (4): 418–421.

    Article  Google Scholar 

  4. Dimich I, Singh PP, Adell A, Hendler M, Sonnenklar N, Jhaveri M . Evaluation of oxygen saturation monitoring by pulse oximetry in neonates in the delivery system. Can J Anaesth 1991; 38 (8): 985–988.

    Article  CAS  Google Scholar 

  5. Kamlin COF, O’Donnell CPF, Davis PG, Morley CJ . Oxygen saturation in healthy infants immediately after birth. J Pediatr 2006; 148: 585–589.

    Article  Google Scholar 

  6. House JT, Schultetus RR, Gravenstein N . Continuous neonatal evaluation in the delivery room by pulse oximetry. J Clin Monit 1987; 3 (2): 96–100.

    Article  CAS  Google Scholar 

  7. Wang CL, Anderson C, Leone TA, Rich W, Govindaswami B, Finer NN . Resuscitation of preterm neonates by using room air or 100% oxygen. Pediatr 2008; 121: 1083–1089.

    Article  Google Scholar 

  8. Escrig R, Arruza L, Izquierdo I, Villar G, Sa’enz P, Gimeno A et al. Achievement of targeted saturation values in extremely low gestational age neonates resuscitated with low or high oxygen concentrations: a prospective randomized trial. Pediatr 2008; 121: 875–881.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neonatal-Perinatal Medicine, Pitt County Memorial Hospital, East Carolina University, Greenville, NC, USA

    K Lanka & J J Cummings

Authors
  1. K Lanka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J J Cummings
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K Lanka.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lanka, K., Cummings, J. Initiating preterm resuscitation with less than 100% oxygen. J Perinatol 30, 366 (2010). https://doi.org/10.1038/jp.2010.2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2010.2

Search

Advanced search

Quick links