alexa Room-air versus oxygen administration for resuscitation of preterm infants: the ROAR study.


Journal of Pulmonary & Respiratory Medicine

Author(s): Rabi Y, Singhal N, NettelAguirre A

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Abstract OBJECTIVE: We conducted a blinded, prospective, randomized control trial to determine which oxygen-titration strategy was most effective at achieving and maintaining oxygen saturations of 85\% to 92\% during delivery-room resuscitation. METHODS: Infants born at 32 weeks' gestation or less were resuscitated either with a static concentration of 100\% oxygen (high-oxygen group) or using an oxygen-titration strategy starting from a concentration of 100\% (moderate-oxygen group), or 21\% oxygen (low-oxygen group). In the moderate- and low-oxygen groups, the oxygen concentration was adjusted by 20\% every 15 seconds to reach a target oxygen saturation range of 85\% to 92\%. Treatment failure was defined as a heart rate slower than 100 beats per minute for longer than 30 seconds. RESULTS: The moderate-oxygen group spent a greater proportion of time in the target oxygen saturation range (mean: 0.21 [95\% confidence interval: 0.16-0.26]) than the high-oxygen group (mean: 0.11 [95\% confidence interval: 0.09-0.14]). Infants in the low-oxygen group were 8 times more likely to meet the criteria for treatment failure than those in the high-oxygen group (24\% vs 3\%; P = .022). The 3 groups did not differ significantly in the time to reach the target oxygen saturation range. CONCLUSIONS: Titrating from an initial oxygen concentration of 100\% was more effective than giving a static concentration of 100\% oxygen in maintaining preterm infants in a target oxygen saturation range. Initiating resuscitation with 21\% oxygen resulted in a high treatment-failure rate. This article was published in Pediatrics and referenced in Journal of Pulmonary & Respiratory Medicine

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