AUTHOR=Garcia-Hidalgo Catalina , Cheung Po-Yin , Solevåg Anne Lee , Vento Maximo , O'Reilly Megan , Saugstad Ola , Schmölzer Georg M. 

TITLE=A Review of Oxygen Use During Chest Compressions in Newborns—A Meta-Analysis of Animal Data

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 6 - 2018

YEAR=2018

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2018.00400

DOI=10.3389/fped.2018.00400

ISSN=2296-2360

ABSTRACT=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.