Kim Esther, Nguyen Margaret
Department of Pediatrics, Division of Neonatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.
Neoreviews. 2019 Sep;20(9):e500-e512. doi: 10.1542/neo.20-9-e500.
Oxygen is commonly used in the delivery room during neonatal resuscitation. The transition from intrauterine to extrauterine life is a challenge to newborns, and exposure to too much oxygen can cause an increase in oxidative stress. The goal of resuscitation is to achieve normal oxygen levels as quickly as possible while avoiding excessive oxygen exposure and preventing inadequate oxygen supplementation. Although it has been shown that room air resuscitation is as effective as using 100% oxygen, often preterm infants need some degree of oxygen supplementation. The ideal concentration of oxygen with which to initiate resuscitation is yet to be determined. Current delivery room resuscitation guidelines recommend the use of room air for term newborns and preterm newborns of greater than or equal to 35 weeks' gestation and the use of a fraction of inspired oxygen of 0.21 to 0.3 for preterm infants of less than 35 weeks' gestation. Further recommendations include titrating oxygen supplementation as needed to obtain goal saturations. However, there is no current consensus on an intermediate oxygen concentration to start resuscitation or goal range saturations for preterm and asphyxiated term infants.
在新生儿复苏过程中，产房通常会使用氧气。从宫内生活过渡到宫外生活对新生儿来说是一项挑战，而暴露于过多氧气会导致氧化应激增加。复苏的目标是尽快实现正常的氧水平，同时避免过度吸氧并防止氧补充不足。尽管已表明空气复苏与使用100%氧气一样有效，但早产婴儿通常需要一定程度的氧补充。启动复苏的理想氧浓度尚未确定。当前的产房复苏指南建议，对于足月儿和妊娠35周及以上的早产儿使用空气进行复苏，对于妊娠小于35周的早产儿使用吸入氧分数为0.21至0.3的氧气进行复苏。进一步的建议包括根据需要调整氧补充量以达到目标饱和度。然而，目前对于开始复苏的中间氧浓度或早产和窒息足月儿的目标饱和度范围尚无共识。
