Torrejón-Rodríguez Laura, Solaz-García Álvaro, Lara-Cantón Inmaculada, Pinilla-González Alejandro, Aguar Marta, Vento Máximo
Division of Neonatology, University and Polytechnic Hospital La Fe (HULAFE), Valencia 46026, Spain.
Neonatal Research Group, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia 46026, Spain.
Matern Fetal Med. 2023 Oct 20;5(4):244-247. doi: 10.1097/FM9.0000000000000206. eCollection 2023 Oct.
Extreme preterm infants (<28 weeks' gestation) often require positive pressure ventilation with oxygen during postnatal stabilization in the delivery room. To date, optimal inspired fraction of oxygen (FiO) still represents a conundrum in newborn care oscillating between higher (>60%) and lower (<30%) initial FiO. Recent evidence and meta-analyses have underscored the predictive value for survival and/or relevant clinical outcomes of the Apgar score and the achievement of arterial oxygen saturation measured by pulse oximetry ≥85% at 5 minutes after birth. New clinical trials comparing higher versus lower initial FiO have been launched aiming to optimize postnatal stabilization of extreme preterm while avoiding adverse effects of hypoxemia or hyperoxemia.
极早产儿(妊娠<28周)在产房出生后稳定期通常需要进行正压通气并吸氧。迄今为止,最佳吸氧浓度(FiO)在新生儿护理中仍是一个难题,初始FiO在较高(>60%)和较低(<30%)之间波动。最近的证据和荟萃分析强调了阿氏评分以及出生后5分钟经脉搏血氧饱和度测定动脉血氧饱和度≥85%对生存和/或相关临床结局的预测价值。已开展了比较高初始FiO与低初始FiO的新临床试验,旨在优化极早产儿出生后的稳定期,同时避免低氧血症或高氧血症的不良影响。