Room air resuscitation of the depressed newborn: A systematic review and meta-analysis

Understanding of the potential dangers of hyperoxia in the newborn is growing. Several studies have examined the use of room air for the resuscitation of newborns. Objective: To assess the effects of room air resuscitation versus 100% oxygen resuscitation on mortality at 1 week and 1 month in asphyxiated newborn infants. Study design: Systematic review and meta-analysis of seven randomized and quasi-randomised controlled trials comparing room air and 100% oxygen resuscitation of newborn infants. Results: Compared to the 100% oxygen resuscitation group, neonates in the room air resuscitation group had a lower mortality both in the first week of life (odds ratio 0.70, 95% Cl 0.50, 0.98) and at 1 month and beyond (odds ratio 0.63, 95% Cl 0.42, 0.94). The incidence of severe hypoxic ischemic encephalopathy (Stage II and Stage III) was similar between the two groups. Conclusion: This meta-anatysis supports the hypothesis that room air is superior to 100% oxygen as the initial choice for resuscitating clinically depressed newborns as it may result in a lower mortality rate. However, adequately powered studies of long-term neurodevetopmental outcomes are not yet available. (c) 2006 Elsevier Ireland Ltd. All rights reserved.