Use of oxygen in the resuscitation of preterm infants: Current opinion and practice in Australia and New Zealand
Article first published online: 19 JAN 2009
© 2008 The Authors. Journal compilation © 2008 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 45, Issue 1-2, pages 31–35, January/February 2009
How to Cite
Clark, R. L., Lui, K. and Oei, J. L. (2009), Use of oxygen in the resuscitation of preterm infants: Current opinion and practice in Australia and New Zealand. Journal of Paediatrics and Child Health, 45: 31–35. doi: 10.1111/j.1440-1754.2008.01430.x
- Issue published online: 19 JAN 2009
- Article first published online: 19 JAN 2009
- Accepted for publication 17 June 2008.
- premature infant;
Aim: The aim of this paper was to explore the opinions and practices of tertiary health-care professionals in Australia and New Zealand regarding air and oxygen blending (OB) for the resuscitation of preterm infants.
Methods: Structured questionnaires were sent to the directors of 25 tertiary perinatal units, with instructions to distribute the questionnaires to 15 pertinent clinical staff.
Results: Response rate was 72% (n = 271); medical-staff response was 25%. Sixteen (64%) perinatal units had OB resuscitation equipment. Among respondents, 114 (42%) had access to OB and 73 (27%) had OB for all resuscitations. Pulse oximetry was available to 160 (59%) of respondents. The majority (173, 64%) would initiate resuscitation with Fractional inspired oxygen (FiO2) ranging from 0.3 to 0.9 (mean 0.5), with 15% and 21% preferring air and 100% oxygen, respectively. There were large variations in managing FiO2 changes thereafter. Half of the respondents were either unsure (39%) or not convinced (15%) that 100% oxygen during resuscitation would cause harm. Conversely, 42% suggested that OB might improve outcome with bronchopulmonary dysplasia and retinopathy of prematurity being the most important considerations. Most (92%) would advocate for OB in the delivery suite. Set-up cost (50%) and lack of guided experience (38%) ranked highest as barriers to change.
Conclusions: Two-thirds of the tertiary centres have at least some OB equipment in the delivery suite, but the ways and opinions in which OB is utilised differ widely. Most practitioners would advocate for a change. There is an urgent need for further research to achieve a consistent and meaningful clinical management for OB resuscitation of preterm infants.