Oxygen for the resuscitation of newborn infants

Abstract

Fetal to neonatal transition is characterized by abrupt changes in the cardio-respiratory physiology. In few minutes, the newly born infant expands the lungs, diminishes pulmonary vascular resistance dilating the pulmonary vessels, and establishes a highly efficient gas exchange between alveoli and the pulmonary capillary bed. However, under certain pathologic conditions asphyxia ensues. Asphyxia is characterized by prolonged periods of hypoxia and ischemia that cause brain energy exhaustion leading in many occasions to a hypoxic ischemic encephalopathy. The cornerstones of newborn resuscitation consist in the establishment of a functional residual capacity and an adequate oxygenation. Of note, the need for oxygen during resuscitation varies substantially between term and preterm infants as has been shown in physiologic studies. The aim of this review article is to present updated knowledge in the management of oxygen in the delivery room both in term babies suffering from birth asphyxia and in preterm babies needing aid to overcome postnatal adaptation.

Keywords

Oxygen - fetal-to-neonatal transition - resuscitation - oxidative stress - pulse oximetry