HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) All Versions of this Article: adc.2004.059287v1 90/5/F401    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in ADC Online Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Harling, A E Articles by Yoxall, C W Search for Related Content PubMed PubMed Citation Articles by Harling, A E Articles by Yoxall, C W

Does the use of 50% oxygen at birth in preterm infants reduce lung injury?

¹ NICU, Liverpool Women’s Hospital, Liverpool L8 7SS, UK
² Immunology Department, University of Liverpool, Liverpool L69 3GA

Correspondence to:
Correspondence to:
Miss Harling
Neonatal Intensive Care Unit, Liverpool Women’s Hospital, Crown Street, Liverpool L8 7SS, UK; Elizabeth.Harling{at}lwh-tr.nwest.nhs.uk

Background: Bronchopulmonary dysplasia is an inflammatory fibrotic condition produced as a consequence of injurious influences in the neonatal lung. Exposing the premature lung to high concentrations of oxygen is thought to play an important part in lung injury pathogenesis.

Objective: To see if the amount of oxygen used during resuscitation at birth triggers events that lead to the subsequent lung injury and if a reduction in oxygen used leads to a reduction in lung injury.

Method: The outcomes of newborn babies less than 31 weeks gestation who were resuscitated using either 50% or 100% oxygen were examined. Eight of the babies receiving 50% oxygen required an increase in their oxygen concentration. Evidence of pulmonary inflammation was determined by quantifying interleukin 6, 1ß, and 10 and tumour necrosis factor in bronchoalveolar lavage fluid by enzyme linked immunosorbent assay.

Results: There were no significant differences in any of the cytokines studied in either of the groups. Death occurred in 5/26 (19%) babies who received 100% oxygen and 4/26 (15%) babies who received 50% oxygen. Survival without bronchopulmonary dysplasia at 36 weeks postmenstrual age occurred in 14/26 (54%) and 13/26 (50%).

Conclusion: Reducing the oxygen to 50% at resuscitation did not influence either short or long term outcomes, but a small benefit could not be excluded. There was no increase in adverse clinical outcomes in babies who received 100% oxygen.

Abbreviations: BAL, bronchoalveolar lavage; BPD, bronchopulmonary dysplasia; IL, interleukin; PIP, peak inspiratory pressure; ROS, reactive oxygen species; TNF, tumour necrosis factor

Keywords: bronchoalveolar lavage fluid; bronchopulmonary dysplasia; cytokines; oxygen

This article has been cited by other articles:

				C P F O'Donnell, A T Gibson, and P G Davis Pinching, electrocution, ravens' beaks, and positive pressure ventilation: a brief history of neonatal resuscitation. Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2006; 91(5): F369 - F373. [Abstract] [Full Text] [PDF]