Challenges in Selecting the Right Oxygen Delivery Devices in Neonatal Intensive Care Unit in Developing Countries

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Abstract Oxygen is a life-saving drug but it may be dangerous if not used properly. Preterm babies are more susceptible to oxygen-induced free radical damage due to their organ immaturity. When supplementing oxygen in newborns, we must evaluate the equipment’s effectiveness, acceptability, tolerance, nasal injuries, and cost-effectiveness. The two most common time-trusted equipment used in neonatal intensive care units (NICUs) are nasal prongs and oxygen hood. The developed countries are using servo-controlled devices and are continuously monitoring the FiO2 and oxygen levels by the analyzer, but it is impractical in developing countries due to the unavailability of the equipment and financial constraints. We are lacking such sophisticated equipment which can monitor all parameters and are servo mode, especially the oxygen hood. Both equipment has got own merits and demerits, and there are no clear-cut guidelines that which one is better. The proper guidelines regarding the use, indications, methods, and monitoring of oxygen therapy in newborn babies are not clear. Many of the staff working in NICU are the ignorant about the nature of complications and side effects and the need for follow-up. This article highlights the rationale of oxygen therapy and saturation policy, methods of weaning, comparison of the efficacy, merits, and demerits, and implications of oxygen delivery devices in the care of newborns in NICU mostly in developing countries.