| Tailoring oxygen needs of extremely low birth weight infants in the delivery room. | |
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MedLine Citation:
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PMID: 21701207 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Fetal to neonatal transition poses an extraordinary challenge for the extremely low birth weight (ELBW) neonate. Indeed a significant number of ELBW neonates will need proactive resuscitation to achieve postnatal stabilization. Positive pressure ventilation and oxygenation are the most relevant interventions in the delivery room (DR). Oxygen needs during resuscitation still represent a conundrum for neonatologists. While hyperoxemia favors oxidative stress and subsequent organ injury, hypoxemia is associated with long-term neurodevelopmental impairment. It has been shown that ELBW neonates can be successfully resuscitated with lower concentrations of oxygen as had been done traditionally. Moreover, reducing oxygen load has resulted in achievement of arterial partial pressures of oxygen at admission closer to the physiologic range, less oxidative stress and less inflammation. The availability of reference ranges for arterial oxygen saturation (SpO(2)) for ELBW neonates in the first 10 min after birth has been an extraordinary step forward in our ability to individually titrate oxygen needs thus avoiding the risks of both hypo- and hyperoxemia. The optimal fraction of inspired oxygen (FiO(2)) to initiate resuscitation and the safest SpO(2) percentiles for ELBW neonates during the first minutes of life are still unknown and will need further research in the future. Until then, optimal ventilation at birth and individually tailoring FiO(2) according to the nomogram seem to be the most reasonable and safe approach. |
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Authors:
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Máximo Vento |
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Publication Detail:
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Type: Journal Article Date: 2011-06-23 |
Journal Detail:
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Title: Neonatology Volume: 99 ISSN: 1661-7819 ISO Abbreviation: Neonatology Publication Date: 2011 |
Date Detail:
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Created Date: 2011-06-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101286577 Medline TA: Neonatology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 342-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 S. Karger AG, Basel. |
Affiliation:
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Health Research Institute, Hospital La Fe, and Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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