Oxygen saturation and heart rate during delivery room resuscitation of infants <30 weeks' gestation with air or 100% oxygen

Background: Because of concerns about harmful effects of 100% oxygen on newborn infants, air has started to be used for resuscitation in the delivery room. Objective: To describe changes in preductal oxygen saturation (Spo(2)) and heart rate (HR) in the first 10 min after birth in very preterm infants initially resuscitated with 100% oxygen (OX100) or air (OX21). Patients and methods: In July 2006, policy changed from using 100% oxygen to air. Observations Of Spo(2) arid HR before and after the change were recorded whenever a member of the research team was available to attend the birth. Results: There were 20 infants in the OX100 group and 106 in the OX21 group. In the OX100 group, Spo2 had risen to a median of 84% after 2 min and 94% by 5 min. in the OX21 group, median Spo(2) was 31% at 2 min and 54% at 5 min. In the OX21 group, 92% received supplemental oxygen at a median of 5 min, the Spo2 rose to a median of 81% by 6 min. In the first 10 min after birth, 80% and 55% of infants in the OX100 and OX21 groups, respectively, had an Spo(2) >= 95%. Increases in HR over the first 10 min were very similar in the two groups. Conclusions: Most very preterm infants received supplemental oxygen it air was used for the initial resuscitation. In these infants, the use of backup 100% oxygen and titration against Spo(2) resulted in a similar course to "normal" term and preterm infants. Of the infants resuscitated with 100% oxygen, 80% had Spo(2) >= 95% during the first 10 min. The HR changes in the two groups were very similar.