School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia; Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia.
Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia.
Semin Fetal Neonatal Med. 2021 Apr;26(2):101220. doi: 10.1016/j.siny.2021.101220. Epub 2021 Feb 24.
For more than 200 years, pure oxygen was given ad libitum to newborn infants requiring resuscitation. Due to oxidative stress and injury concerns, a paradigm shift towards using "less" oxygen, including air (21% oxygen) instead of pure (100%) oxygen, occurred about twenty years ago. A decade later, clinicians were advised to adjust fractional inspired oxygen (FiO) to target oxygen saturations (SpO) that were derived from spontaneously breathing, healthy, mature infants. Whether these recommendations are achievable, beneficial, harmful or redundant is uncertain. The underlying pathology leading to resuscitation varies between infants and may considerably alter an infant's response to supplemental oxygen. In this review, we summarize available evidence for the use of SpO monitoring at delivery for newborn infants, elucidate existing knowledge and service gaps, and suggest future research recommendations that will lead to the safest clinical strategies for this standard and important practice.
两百多年来，需要复苏的新生儿一直被给予任意浓度的纯氧。由于氧化应激和损伤的问题，大约二十年前，人们的观念发生了转变，开始使用“较少”的氧气，包括空气（21%的氧气）而不是纯氧（100%的氧气）。十年后，临床医生被建议调整吸入氧分数（FiO），以达到源自自主呼吸、健康、成熟婴儿的目标氧饱和度（SpO）。这些建议是否可行、有益、有害或多余尚不确定。导致复苏的潜在病理在不同婴儿之间有所差异，可能会极大地改变婴儿对补充氧气的反应。在这篇综述中，我们总结了现有关于在分娩时使用 SpO 监测新生儿的证据，阐明了现有知识和服务差距，并提出了未来的研究建议，以制定出这项标准和重要实践的最安全的临床策略。
