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Systematic Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Pediatr. | doi: 10.3389/fped.2018.00400

A review of oxygen use during chest compressions in newborns

  • 1University of Alberta, Canada
  • 2Akershus University Hospital, Norway
  • 3Hospital Universitari i Politècnic La Fe, Spain
  • 4University of Oslo, Norway

Background: International consensus statements for resuscitation of newborn infants recommend provision of 100% oxygen once chest compressions are required. However, 100% oxygen exacerbates reperfusion injury and reduces cerebral perfusion in newborn babies.
Objective: We aimed to establish whether resuscitation with air during chest compression is feasible and safe in newborn infants compared with 100% oxygen.
Methods: Systematic search of PubMed, Google Scholar and CINAHL for articles examining variable oxygen concentrations during chest compressions in term newborns.
Results: Overall, no human studies but eight animal studies (n=323 animals) comparing various oxygen concentrations during chest compression were identified. The pooled analysis showed no difference in mortality rates for animals resuscitated with air versus 100% oxygen (risk ratio 1.04 [0.35, 3.08], I2=0%, p=0.94). ROSC was also similar between groups with a mean difference of -3.8 [-29.7 – 22] sec, I2=0%, p=0.77. No difference in oxygen damage or adverse events were identified between groups.
Conclusions: Air had similar time to ROSC and mortality as 100% oxygen during neonatal chest compression. A large randomized controlled clinical trial comparing air vs. 100% oxygen during neonatal chest compression is warranted.

Keywords: Newborn, Delivery room resuscitation, Infant, Oxygen, Cardiopulmonary Resuscitation

Received: 26 Oct 2018; Accepted: 03 Dec 2018.

Edited by:

Karel Allegaert, University Hospitals Leuven, Belgium

Reviewed by:

Jeroen Van Vonderen, Leiden University Medical Center, Netherlands
Antonio Rodriguez-Nunez, University of Santiago de Compostela, Spain  

Copyright: © 2018 Garcia-Hidalgo, Cheung, Solevåg, VENTO, O'Reilly, Saugstad and Schmolzer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Georg Schmolzer, University of Alberta, Edmonton, T6G 2R3, Alberta, Canada,