• Jeroen J van Vonderen, Nadia E Narayen, Frans J Walther, Melissa L Siew, Peter G Davis, Stuart B Hooper, and Arjan B te Pas.
• Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
• Plos One. 2013 Jan 1;8(10):e76898.

AimTo retrospectively investigate the changes of SpO2 and respiratory drive in preterm infants at birth after administration of 100% oxygen.MethodsRespiratory parameters, FiO2 and oximetry of infants <32 weeks gestation before and after receiving FiO2 1.0 were reviewed during continuous positive airway pressure (CPAP) or positive pressure ventilation (PPV).ResultsResults are given as median (IQR) or percentages where appropriate. Suitable recordings were made in 50 infants (GA 27 (26-29) weeks), 17 received CPAP and 33 PPV. SpO2 increased rapidly in the first minute after FiO2 1.0 and remained stable. The duration of FiO2 1.0 tended to be shorter in the CPAP group than in the PPV group (CPAP vs. PPV: 65 (33-105) vs. 100 (40-280) s; p = 0.05), SpO2 >95% occurred more often in PPV group (53% vs. 69%) and lasted longer (70(40-95) vs. 120(50-202) s). In CPAP group, minute volume increased from 134 (76-265) mL/kg/min 1 minute before to 240 (157-370) mL/kg/min (p<0.01) 1 minute after start FiO2 1.0 and remained stable at 2 minutes (252 (135-376) mL/kg/min; ns). The rate of rise to maximum tidal volume increased (from 13.8 (8.0-22.4) mL/kg/s to 18.2 (11.0-27.5) mL/kg/s; p<0.0001) to 18.8 (11.8-27.8) mL/kg/s; ns). In the PPV group respiratory rate increased from 0(0-4) to 9(0-20) at 1 minute (p<0.001) to 23 (0-34) breaths per minute at 2 minutes (p<0.01).ConclusionIn preterm infants at birth, a rapid increase in oxygenation, resulting from a transient increase to 100% oxygen might improve respiratory drive, but increases the risk for hyperoxia.

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