Oxygenation of Newborns

Abstract

The last 20–30 years, the oxygen exposure of newborn infants has been substantially reduced. This is mainly due to a dramatic reduction in the use of oxygen in the delivery room in newborn infants in need of positive pressure ventilation (PPV) and the better control of oxygen saturation with clearly defined targets in immature infants in need of supplemental oxygen during treatment in neonatal intensive care units. Term and near-term infants in need of IPPV in the delivery room should start with a FiO2 of 0.21. Between 28 and 31 weeks of gestation, an initial FiO2 of 0.21–0.30 is generally recommended. For immature infants, a higher FiO2 than 0.3 may be needed, although the optimal initial level is not defined. For all groups, it is recommended to adjust the FiO2 according to oxygen saturation (SpO2) and heart rate response. For immature infants, the combination of prolonged bradycardia and an SpO2 not reaching 80% within 5 min of life is associated with a substantially increased risk of death. For immature infants beyond the delivery room, an SpO2 target between 91 and 95% is recommended.