Air versus oxygen for resuscitation of infants at birth

摘要: Background 100% oxygen is the commonly recommended gas for resuscitation of infants at birth. There growing evidence from both animal and human studies that room air as effective 100% may have adverse effects on breathing physiology cerebral circulation. also theoretical risk tissue damage due to free radicals when given. The use has, therefore, been suggested a safer possibly more alternative. Objectives In newborn requiring resuscitation, does reduce incidence death, neurological disability short term morbidity compared with oxygen? Search strategy This included searches Oxford Database Perinatal Trials, Cochrane Central Register Controlled Trials (CENTRAL, Library, Issue 1, 2004) MEDLINE PubMed 1966 December 2003, handsearches reference lists relevant articles conference proceedings. Selection criteria All randomised quasi-randomised comparing or any other concentration versus in birth. Data collection analysis Three authors assessed methodological quality eligible trials extracted data independently. When appropriate, meta-analysis was conducted provide pooled estimate effect. For categorical relative (RR), difference (RD) number needed treat (NNT) 95% confidence intervals (CI) were calculated. Continuous analysed using weighted mean (WMD). Main results Five identified which enrolled total 1302 infants. In two allocation caregivers blinded intervention group. three studies, not blinded. Pooled analysis four reporting effect death showed significant reduction rate group resuscitated [typical RR 0.71 (0.54, 0.94), typical RD -0.05 (-0.08, -0.01), NNT 20 (12, 100)]. no differences between groups respect rates grade 2 3 hypoxic ischaemic encephalopathy. One reported statistically median 5 minute Apgar scores, favouring allocated air. However, absolute medians small there 10 scores this outcome. One trial followed up selected subgroup survivors 18-24 months. neurodevelopmental outcomes including palsy failure achieve various milestones; however, proportion patients seen less than 70%. Analyses planned review, but able be carried out because lack published data, sub-analysis stratified by gestational age assessments bronchopulmonary dysplasia retinopathy prematurity. Authors' conclusions There insufficient present recommend policy over oxygen, vice versa, resuscitation. A mortality has air, harm demonstrated. their methodologic limitations dictate caution interpreting applying these results. We note back-up quarter Therefore, basis currently available evidence, if one chooses initial supplementary should continue made available. PLAIN LANGUAGE SUMMARY Synopsis pending. Copyright © 2006 Collaboration. Published John Wiley & Sons, Ltd.