Resuscitating preterm infants with 100% oxygen is associated with higher oxidative stress than room air

Tataranno, Maria Luisa; Oei, Ju Lee; Perrone, Serafina; Wright, Ian; Smyth, John; Lui, Kei; Tarnow‐Mordi, William; Longini, Mariangela; Proietti, Fabrizio; Negro, Simona; Saugstad, Ola Didrik; Buonocore, Giuseppe

doi:10.1111/apa.13039

Cited by 37 publications

(29 citation statements)

References 30 publications

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“…Although previous investigators demonstrated increased urinary F 2 ‐isoprostane concentrations for up to 12 hours after birth when infants were exposed to PROM or 100% oxygen for resuscitation at delivery, our findings revealed no impact from these associated risk factors over the 21‐day postbirth study period. Because these previous studies measured oxidative stress only through to 12 hours postbirth, it is possible that high‐dose HM feedings may partially neutralize these initial perinatal oxidation risks in the premature infant population.…”

Section: Discussioncontrasting

confidence: 94%

High‐Dose Human Milk Feedings Decrease Oxidative Stress in Premature Infant

Chen

Fantuzzi

Schoeny

et al. 2018

J Parenter Enteral Nutr

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Section: Discussioncontrasting

confidence: 94%

High‐Dose Human Milk Feedings Decrease Oxidative Stress in Premature Infant

Chen

Fantuzzi

Schoeny

et al. 2018

J Parenter Enteral Nutr

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“…FiO 2 can be adjusted according to the response of the patients’ heart rate and oxygen saturation. Tataranno et al, found a significant increase in plasma levels of advanced oxidative protein products and isoprostanes 12 h after birth in preterm babies receiving 100% oxygen [73]. Similarly, Vento et al [18] compared resuscitation of extremely preterm infants randomly assigned to receive positive pressure ventilation of the airways with a gas admixture that contained a lower oxygen concentration of 30% (LowOx) vs. a higher oxygen concentration of 90% (HiOx).…”

Section: Introductionmentioning

confidence: 99%

Oxygen and oxidative stress in the perinatal period

et al. 2017

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Fetal life evolves in a hypoxic environment. Changes in the oxygen content in utero caused by conditions such as pre-eclampsia or type I diabetes or by oxygen supplementation to the mother lead to increased free radical production and correlate with perinatal outcomes.In the fetal-to-neonatal transition asphyxia is characterized by intermittent periods of hypoxia ischemia that may evolve to hypoxic ischemic encephalopathy associated with neurocognitive, motor, and neurosensorial impairment. Free radicals generated upon reoxygenation may notably increase brain damage. Hence, clinical trials have shown that the use of 100% oxygen given with positive pressure in the airways of the newborn infant during resuscitation causes more oxidative stress than using air, and increases mortality.Preterm infants are endowed with an immature lung and antioxidant system. Clinical stabilization of preterm infants after birth frequently requires positive pressure ventilation with a gas admixture that contains oxygen to achieve a normal heart rate and arterial oxygen saturation. In randomized controlled trials the use high oxygen concentrations (90% to 100%) has caused more oxidative stress and clinical complications that the use of lower oxygen concentrations (30–60%). A correlation between the amount of oxygen received during resuscitation and the level of biomarkers of oxidative stress and clinical outcomes was established. Thus, based on clinical outcomes and analytical results of oxidative stress biomarkers relevant changes were introduced in the resuscitation policies. However, it should be underscored that analysis of oxidative stress biomarkers in biofluids has only been used in experimental and clinical research but not in clinical routine. The complexity of the technical procedures, lack of automation, and cost of these determinations have hindered the routine use of biomarkers in the clinical setting. Overcoming these technical and economical difficulties constitutes a challenge for the immediate future since accurate evaluation of oxidative stress would contribute to improve the quality of care of our neonatal patients.

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“…The oxygen challenge may promote the observed adenosine increase. It has been assessed that initial resuscitation in air is preferable to 100% oxygen, as oxidative stress is among the causes of periventricular white matter lesions …”

Section: Introductionmentioning

confidence: 99%