Chabernaud J-L
SMUR pédiatrique (SAMU 92) et réanimation néonatale, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France.
Arch Pediatr. 2009 Aug;16(8):1194-201. doi: 10.1016/j.arcped.2009.04.008. Epub 2009 May 29.
Most of the contemporary guidelines on newborn resuscitation are based on experience but lack scientific evidence. The use of 100% oxygen is one of the more evident. Today, these practices are questioned, particularly for the resuscitation of moderately depressed full-term or near-term newborns. Results of recent meta-analysis of trials that compared ventilation with room air versus pure oxygen at birth suggest current practices should be revisited. On the basis of these data, air can be the initial gas to use for these babies. Large-scale trials, including preterm and cause and/or severity of initial asphyxia, must now be undertaken before the publication of new guidelines for these populations.
大多数当代新生儿复苏指南是基于经验制定的,但缺乏科学依据。使用100%氧气就是其中较为明显的一例。如今,这些做法受到了质疑,尤其是对于中度窒息的足月儿或近足月儿的复苏。近期对出生时使用空气与纯氧进行通气比较的试验的荟萃分析结果表明,当前的做法应该重新审视。基于这些数据,空气可以作为这些婴儿最初使用的气体。在为这些人群发布新指南之前,现在必须进行大规模试验,包括针对早产儿以及初始窒息的原因和/或严重程度的试验。