Simple method of <100% oxygen resuscitation for preterm infants

Abstract

The aim of this study was to determine the feasibility of 50-60% oxygen resuscitation by a simple method using a self-inflation bag without oxygen reservoir for positive pressure ventilation (PPV) or using a constant distance and flow rate for blow-by oxygen. Newborn infants ≤ 35 weeks gestational age were eligible. Infants requiring PPV were initiated with bag-mask PPV without oxygen reservoir. Nearly 100% oxygen was given by attaching oxygen reservoir if heart rate < 100 beats/min after PPV for 90 s or SpO(2) < 75% at 3 min. For those requiring blow-by oxygen, oxygen flow 5 L/min via facemask was given 5 cm from the nose. Almost 100% oxygen was given by close-fitting facemask to nose if SpO(2) < 80% at 5 min. Ninety-one infants were eligible; 67 of them required resuscitation. Thirty-five infants required PPV; 27 (77.1%) responded to bag-mask PPV without oxygen reservoir. For 32 infants requiring blow-by oxygen, 28 (87.5%) reached the targeted SpO(2). No significant differences in clinical outcomes were observed between responders and non-responders. The technique of <100% oxygen supplementation was effective for preterm newborn resuscitation with a high success rate. This technique may be useful for a limited-resource setting.