AUTHOR=Garcia-Hidalgo Catalina , Cheung Po-Yin , Solevåg Anne Lee , Vento Maximo , O'Reilly Megan , Saugstad Ola , Schmölzer Georg M. 

TITLE=A Review of Oxygen Use During Chest Compressions in Newborns—A Meta-Analysis of Animal Data

JOURNAL=Frontiers in Pediatrics

VOLUME=6

YEAR=2018

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2018.00400

DOI=10.3389/fped.2018.00400

ISSN=2296-2360

ABSTRACT=<p><bold>Background:</bold> International consensus statements for resuscitation of newborn infants recommend provision of 100% oxygen once chest compressions are required. However, 100% oxygen exacerbates reperfusion injury and reduces cerebral perfusion in newborn babies.</p><p><bold>Objective:</bold> We aimed to establish whether resuscitation with air during chest compression is feasible and safe in newborn infants compared with 100% oxygen.</p><p><bold>Methods:</bold> Systematic search of PubMed, Google Scholar and CINAHL for articles examining variable oxygen concentrations during chest compressions in term newborns.</p><p><bold>Results:</bold> Overall, no human studies but eight animal studies (<italic>n</italic> = 323 animals) comparing various oxygen concentrations during chest compression were identified. The pooled analysis showed no difference in mortality rates for animals resuscitated with air vs. 100% oxygen (risk ratio 1.04 [0.35, 3.08], I<sup>2</sup> = 0%, <italic>p</italic> = 0.94). ROSC was also similar between groups with a mean difference of −3.8 [−29.7–22] s, I<sup>2</sup> = 0%, <italic>p</italic> = 0.77. No difference in oxygen damage or adverse events were identified between groups.</p><p><bold>Conclusions:</bold> Air had similar time to ROSC and mortality as 100% oxygen during neonatal chest compression. A large randomized controlled clinical trial comparing air vs. 100% oxygen during neonatal chest compression is warranted.</p>