Oxygen and Resuscitation of the Preterm Infant

The use of room air for delivery room resuscitation is gaining rapid acceptance. Several studies to date have shown tangible benefits for using room air rather than 100% oxygen, although they are largely limited to asphyxiated term infants. There are several important differences between term and preterm babies in the challenges faced during transition that result largely from differences in pulmonary physiology and antioxidant capabilities. More recently, evidence is emerging about the applicability of room air for resuscitation of the preterm population. These studies demonstrate that the inspired oxygen concentration can be titrated to reach a target oxygen saturation in the delivery room. However, they also raise important questions as to the best concentration of oxygen to use when initiating resuscitation.