Recent discussions
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ILCOR Staff
I agree that beginning with 21% O2 is appropriate for the newborn born at 35+ weeks gestation. The goal is to support initiation of spontaneous respiration and closure of the ductus arteriosus. The current NRP guidelines are very clear that when 21% is not effective, one can transition to a higher percentage of O2. It would be useful to provide information on the normal range of O2 saturation of the well fetus to highlight that this is a period of transition, best supported with an intact cord (https://www.nature.com/articles/jp2016151 and https://www.frontiersin.org/articles/10.3389/fped.2017.00001/full) to assure a gradual increase in oxygenation and blood volume while respirations are being established. This is consistent with providing 21% O2 in the first 30 seconds of respiratory support. The resilient neonate will typically respond in the first 30 seconds, and when continued respiratory support is required, titration O2 levels is appropriate, based on heart rate or SPO2 levels. Including information on underlying physiology is very helpful to support continued learning for those providing neonatal resuscitation, and to illustrate why 21% O2 is appropriate. Use of 21% O2 also would allow for initial PPV at the field during cesarean with a sterile bag-valve-mask device, while maintaining an intact cord during initiation of respirations. -
ILCOR Staff
I completely agree with the statement issued -
ILCOR Staff
I agree that starting at 21%. -
ILCOR Staff
I agree with the recommendation and I firmly believe most of my insecurities are being taken away with the fact that they do recover quite well, in the majority, when we do all the steps in the program. Sometimes I do fell a bit of doubt when we have vigorous, but cyanotic babies. -
ILCOR Staff
Thank you so much for all the information. It sure makes it easier to start with lower concentrations of O2 in smaller babies. -
ILCOR Staff
We are currently beginning with lower Oxygen for all deliveries and following oxygen saturation’s per NRP recommendations. If an infant requires full resuscitation, we will increase oxygen to 100%. -
ILCOR Staff
I agree, too often I see neonatologists starting resuscitation with High oxigen concentration without keeping in mind that in the first minutes of life a newborn CAN'T have 100% saturation! -
ILCOR Staff
Completely agree, in most cases term newborn need just pressure, not oxygen! -
ILCOR Staff
I am agree with the commentaries abovebegin with lower FiO2 and adjust per the patients need. -
ILCOR Staff
The extensive studies and findings are commendable. Looking for answers via evidenced-based practice continues to be the driving force behind finding the answers posted for FIO2 needs for preterm infants, sick infants, etc. and the numerous possible sequelae that can affect them. In our institution, we start off with lowest O2 concentration and increase it based on pre-ductal SpO2 target.