Room-Air Resuscitation Causes Less Damage to Heart and Kidney than 100% Oxygen

Vento, Máximo; Sastre, Juan; Asensi, Miguel; Viña, José

doi:10.1164/rccm.200412-1740oc

Cited by 243 publications

(147 citation statements)

References 37 publications

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“…[6][7][8][9][10][11][12][13] It is only recently that the noxious potential of excess oxygen exposure during the resuscitation of near-term or term infants immediately after birth has been recognized. 14,15 It has therefore been proposed to start neonatal resuscitation in the delivery room by administering a lower FiO 2 , a proposal which has been echoed by several international recommendations on neonatal resuscitation. [16][17][18] There is a growing consensus among neonatologists regarding the need to reduce the FiO 2 in the delivery room, however, the question of the starting FiO 2 value remains a matter of debate.…”

Section: Introductionmentioning

confidence: 99%

Near-Infrared Spectroscopy Measurements of Cerebral Oxygenation in Newborns during Immediate Postnatal Adaptation

Fauchère

Schulz

Haensse

et al. 2010

The Journal of Pediatrics

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Section: Introductionmentioning

confidence: 99%

Near-Infrared Spectroscopy Measurements of Cerebral Oxygenation in Newborns during Immediate Postnatal Adaptation

Fauchère

Schulz

Haensse

et al. 2010

The Journal of Pediatrics

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“…Human (7) and animal studies (8,9) suggest that the origin of the metabolic syndrome can be traced back to perinatal life, a time when newborn infants are at greater risk of oxidative stress caused by weak antioxidant defenses (10 -12) or exposure to an oxidative environment or both (13)(14)(15)(16)(17)(18). Several reports suggest that, in neonates, oxidative stress triggers the events that lead to programming of adult diseases (19 -22).…”

mentioning

confidence: 99%

Neonatal Exposure to Oxidants Induces Later in Life a Metabolic Response Associated to a Phenotype of Energy Deficiency in an Animal Model of Total Parenteral Nutrition

et al. 2010

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Failure to protect total parenteral nutrition (TPN) from ambient light exacerbates the generation of peroxides, which affects blood glucose and plasma triacylglyceride (TG) in neonates. Based on the concept that the origin of adult diseases can be traced back to perinatal life, it was hypothesized that neonatal exposure to peroxides may affect energy availability later in life. Three-day-old guinea pigs, fitted with a jugular catheter, were fed regular chow (sham) Ϯ i. T he association between oxidative stress and characteristic features of the metabolic syndrome, such as diabetes, hypertension, and dyslipidemia, is well documented (1-6). Human (7) and animal studies (8,9) suggest that the origin of the metabolic syndrome can be traced back to perinatal life, a time when newborn infants are at greater risk of oxidative stress caused by weak antioxidant defenses (10 -12) or exposure to an oxidative environment or both (13-18). Several reports suggest that, in neonates, oxidative stress triggers the events that lead to programming of adult diseases (19 -22).Total parenteral nutrition (TPN) represents a source of oxidants in the form of peroxides that can be calibrated either by applying or not photoprotecting. The peroxides are derived from interactions between dissolved oxygen and electron donors such as lipid, amino acid, or ascorbic acid (23,24). The reaction is catalyzed by photoexcited riboflavin (24). Therefore, the main active agents participating in the generation of peroxides in TPN are ambient light [(ϩ)L] and multivitamin preparations (MVP) (23,24). Photoprotection [(Ϫ)L] of TPN reduces the levels of peroxides by close to 50% (23,25,26). Absence of photoprotection of TPN is associated in preterm newborn infants with higher urinary peroxide concentrations (16), higher blood pressure in girl babies (15), and greater blood glucose and plasma triacylglycerol concentrations (13). Hence, peroxides contaminating TPN solutions are not completely quenched by newborns infants and are thought to be an agent initiating metabolic perturbations. We questioned whether these peroxides are linked to metabolic consequences later in life.Based on the concept that neonatal oxidative stress may interfere with metabolic programming (27), we hypothesized that neonatal exposure to peroxides such as those generated in solutions of parenteral nutrition, induces a permanent modification in lipid and glucose metabolism especially lipogenesis and/or glycolysis. Perturbations in lipid and glucose metabolism, which are fuels for energy production, could have longterm consequences on growth and physical activity, thereby affecting global development. The aim of this study was to measure in adult guinea pigs metabolic responses and spontaneous physical activity after a brief neonatal exposure to i.v. oxidant molecules limited to the first wk of life. A second objective was to assess if these modifications were related to the infusion of peroxides. MATERIALS AND METHODSExperimental design. The metabolic response and the levels...

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“…The eight studies retained for analysis included 1,500 patients, 772 in the oxygen group and 728 in the air group. [4][5][6][7][8][9][10][11][12] The exact distribution per country cannot be given because 18 patients originally reported by Saugstad et al 8 were counted twice and need to be subtracted; nevertheless, as originally reported, the distribution would be: India = 1,148; Egypt = 121; Philippines = 26; Estonia = 26; Spain = 85; Denmark = 69; Norway = 2; United States = 41. The risk of bias assessment is given in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…8 Of the four potentially randomized studies (three were said to be randomized, but the exact method was unspecified), three were not designed for clinical outcomes. 5,9,10 In the study by Bajaj et al, 4 the neurological examination at discharge for the survivors in the room air group is missing for 15 patients, while all such data are given for the survivors in the oxygen group. For this study, an abnormal neurological examination at discharge was found in 13.8% of survivors available for follow-up in the oxygen group and 20.0% of the survivors in the room air group.…”

Section: Resultsmentioning

confidence: 99%

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No evidence for superiority of air or oxygen for neonatal resuscitation: a meta-analysis

Guay

Lachapelle

2011

Can J Anesth/J Can Anesth

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Purpose The aim of this meta-analysis was to re-evaluate the evidence in favour of oxygen or room air as the initial gas mixture for neonatal resuscitation in terms of the following outcomes: death, hypoxic/ischemic encephalopathy, need for tracheal intubation, and APGAR score-Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration-at five minutes. Methods A search with no language restriction for all available controlled clinical trials (CCT) was conducted in PUBMED, Cochrane Central Register of Controlled Trials, and EMBASE. Data were extracted independently by the two investigators. Results Eight CCTs were retained for analysis. They included 1,500 patients, 772 in the oxygen group and 728 in the air group. The evidence is based mainly on quasirandomized studies (1,311/1,500) with unblinded resuscitators (1,421/1,500). The expertise/training of the resuscitators was unspecified for four of the eight studies. The risk ratio (RR) for death was 1.35 (95% confidence intervals [CI] = 0.97 to 1.88; P = 0.08; I-squared 0%). The RR for hypoxic/ischemic encephalopathy was 1.03 (95% CI = 0.86 to 1.23; P = 0.74; I-squared 0%). The RR for requiring a tracheal intubation was 0.85 (95% CI = 0.69 to 1.05 [random effects model]; P = 0.12; I-squared = 9.51%). Conclusions The literature is insufficient to make any statement regarding the superiority of oxygen or room air as the initial gas mixture for neonatal resuscitation. RésuméObjectif L'objectif de cette me´ta-analyse e´tait de re´e´valuer les donne´es probantes soutenant la supe´riorited e l'oxyge`ne ou de l'air ambiant en tant que me´lange gazeux initial pour la re´animation ne´onatale en termes des crite`res suivants : de´ce`s, ence´phalopathie hypoxique / ische´mique, besoin d'intubation trache´ale et score APGAR -Apparence (couleur de la peau), Pouls (fre´quence cardiaque), Grimace (irritabilite´re´flexe), Activite´(tonus musculaire) et Respiration -a`cinq minutes.

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Room-Air Resuscitation Causes Less Damage to Heart and Kidney than 100% Oxygen

Abstract: The use of room air on resuscitation causes less oxidative stress and damage to heart and kidney than pure oxygen.

Cited by 243 publications

References 37 publications

Near-Infrared Spectroscopy Measurements of Cerebral Oxygenation in Newborns during Immediate Postnatal Adaptation

Near-Infrared Spectroscopy Measurements of Cerebral Oxygenation in Newborns during Immediate Postnatal Adaptation

Neonatal Exposure to Oxidants Induces Later in Life a Metabolic Response Associated to a Phenotype of Energy Deficiency in an Animal Model of Total Parenteral Nutrition

No evidence for superiority of air or oxygen for neonatal resuscitation: a meta-analysis

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