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Journal of Tropical Pediatrics Advance Access published online on May 31, 2005
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmh086
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© The Author [2005]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Original Papers

Room Air vs. 100 per cent Oxygen for Neonatal Resuscitation: A Controlled Clinical Trial

Naveen Bajaj 1*, Rekha H. Udani 1, and Ruchi N. Nanavati 1

1 Department of Neonatology, Seth GS Medical College & King Edward Memorial Hospital, Parel, Mumbai, India

* To whom correspondence should be addressed.
Naveen Bajaj, E-mail: bajajneo{at}yahoo.com


  Abstract

The aim of the study was to determine whether neonates resuscitated with room air compared with 100 per cent oxygen in the delivery room were less likely to have hypoxic ischemic encephalopathy and/or death before discharge. A controlled clinical trial was carried out at a tertiary care institute. All newborns weighing 1000 g or more with apnea or gasping respiration and/or heart rate less than 100 beats/min requiring positive pressure ventilation after initial steps of resuscitation were included. All eligible neonates were randomized to receive room air or 100 per cent oxygen for the first 90 s after birth if they required positive pressure ventilation. The composite primary outcome variable was hypoxic ischemic encephalopathy (HIE) and/or death before discharge. A total of 204 neonates fulfilling the inclusion criteria were enrolled. Of these, 107 neonates received room air and 97 neonates received 100 per cent oxygen for resuscitation. The composite primary outcome occurred in 41.1 per cent of the neonates assigned to receive room air and 43.3 per cent of those in the 100 per cent oxygen group (odds ratio in the group assigned to room air, 0.92; 95 per cent confidence interval, 0.52-1.60). Resuscitation of a newborn baby with room air instead of the current practice of 100 per cent oxygen does not confer a benefit in terms of reduced HIE and/or mortality. Significantly, there is no increase in adverse outcome with the use of room air, which can be recommended for resuscitation if oxygen is not available.


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