Garcia-Hidalgo Catalina, Cheung Po-Yin, Solevåg Anne Lee, Vento Maximo, O'Reilly Megan, Saugstad Ola, Schmölzer Georg M
Faculty of Science, University of Alberta, Edmonton, AB, Canada.
Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada.
Front Pediatr. 2018 Dec 18;6:400. doi: 10.3389/fped.2018.00400. eCollection 2018.
International consensus statements for resuscitation of newborn infants recommend provision of 100% oxygen once chest compressions are required. However, 100% oxygen exacerbates reperfusion injury and reduces cerebral perfusion in newborn babies. We aimed to establish whether resuscitation with air during chest compression is feasible and safe in newborn infants compared with 100% oxygen. Systematic search of PubMed, Google Scholar and CINAHL for articles examining variable oxygen concentrations during chest compressions in term newborns. Overall, no human studies but eight animal studies ( = 323 animals) comparing various oxygen concentrations during chest compression were identified. The pooled analysis showed no difference in mortality rates for animals resuscitated with air vs. 100% oxygen (risk ratio 1.04 [0.35, 3.08], I = 0%, = 0.94). ROSC was also similar between groups with a mean difference of -3.8 [-29.7-22] s, I = 0%, = 0.77. No difference in oxygen damage or adverse events were identified between groups. Air had similar time to ROSC and mortality as 100% oxygen during neonatal chest compression. A large randomized controlled clinical trial comparing air vs. 100% oxygen during neonatal chest compression is warranted.
新生儿复苏国际共识声明建议，一旦需要进行胸外按压，应提供100%的氧气。然而，100%的氧气会加重再灌注损伤，并降低新生儿的脑灌注。我们旨在确定与100%氧气相比，在新生儿胸外按压期间使用空气进行复苏是否可行且安全。系统检索了PubMed、谷歌学术和CINAHL，以查找研究足月儿胸外按压期间不同氧浓度的文章。总体而言，未发现人体研究，但确定了八项动物研究（n = 323只动物），比较了胸外按压期间的各种氧浓度。汇总分析显示，用空气复苏与用100%氧气复苏的动物死亡率无差异（风险比1.04 [0.35, 3.08]，I² = 0%，P = 0.94）。两组之间的自主循环恢复（ROSC）也相似，平均差异为 -3.8 [-29.7 - 22] 秒，I² = 0%，P = 0.77。两组之间未发现氧损伤或不良事件的差异。在新生儿胸外按压期间，空气与100%氧气的ROSC时间和死亡率相似。有必要进行一项大型随机对照临床试验，比较新生儿胸外按压期间空气与100%氧气的效果。
