Abstract
Postnatal adaptation of preterm infants entails a series of difficulties among which the immaturity of the respiratory system is the most vital. To overcome respiratory insufficiency, caregivers attending in the delivery room use positive pressure ventilation and oxygen. A body of evidence in relation of oxygen management in the delivery room has been accumulated in recent years; however, the optimal initial inspired fraction of oxygen, the time to achieve specific oxygen saturation targets, and oxygen titration have not been yet clearly established. The aim of this review is to update the reader by critically analyzing the most relevant literature.
Highlights
IntroductionThoracic cage structure, and muscular strength only mature late in gestation [1]
Lung cytoarchitecture, thoracic cage structure, and muscular strength only mature late in gestation [1]
The generalization of delayed cord clamping in the delivery room (DR) in preterm infants and clinical trials that are investigating the initiation of ventilation before cord clamping are adding new variables that may influence the oxygen target ranges in preterm infants upon stabilization [13,14]
Summary
Thoracic cage structure, and muscular strength only mature late in gestation [1]. Generalized atelectasis, inability to establish a functional residual capacity, hypoxemia, hypercapnia, and increased work of breathing are the clinical characteristics that describe the respiratory failure of preterm infants when initiating air breathing. Under these circumstances, prenatal interventions such as the administration to the mother of antenatal steroids, and postnatal ventilation and oxygen supplementation to the newborn preterm infants render essential to overcome this dramatic situation [3]. Children 2019, 6, 29 enhances the risk for intraventricular hemorrhage (IVH) and death Both these situations increase mortality and/or short-long term morbidities in survivors [4]. The aim in the present review article is to critically analyze the most relevant and recent literature concerning the use of oxygen in the DR to help neonatologists improving the management of preterm infants during postnatal stabilization
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