March 1, 200717 yr Author Dear 99nicu netters: There is a new article for discussion about our subject (40% oxygen): Hellstrom-Westas L, Forsblad K, Sjors G, Saugstad OD, Bjorklund LJ, Marsal K, Kallen K. Earlier Apgar score increase in severely depressed term infants cared for in Swedish level III units with 40% oxygen versus 100% oxygen resuscitation strategies: a population-based register study. Pediatrics. 2006 Dec;118(6):e1798-804. Do you think that a better Apgar means that 40% is a better oxygen choice? Best Regards, Carlos DELGADO Pediatrician Neonatologist Instituto Nacional de Salud del NiƱo Lima PERU
April 13, 200816 yr We have been using 40% in deliveries for nearly a year now and with good results. It is up to the Neonatologist or NNP to set concentration at delivery. We have also reset our O2 sat limits lower in the NICU to 85-94%. It is driving us nuts because the monitor will alarm if the sats are above 94% as well as below, so you are constantly rechecking your infant. We are trying to find a solution for the higher O2 sats. We can no longer have the O2 sat parameters set at 85-100%. BluelightRN:)
October 19, 200816 yr comment_1523 IT DIFFES WIDELY,e.g.IN PERINATAL ASPHYXIA ,EXTREME P.T.,OR RDS,....etc.,WE USUALLY START WITH 100%O2, OTHERWISE WE CAN START 21% OR 40%
February 24, 201014 yr comment_2967 21% oxygen ( in air,lack /cut off of electricity in our hospital ) is also effective in any resuscitation. In our hospital , air sep ( New intensifier ) was broken down and sent to repair for one month,at that time any resuscitation during this period,we used 21% oxygen in air . It also effective like as 100% oxygen,but a lot of cases had been done longer duration of resuscitation time ( 20min to 30 min )
February 24, 201014 yr comment_2968 I think that 40% oxygen is also better in apgar for severely depressed baby same as 100% oxygen. We have many cases of resuscitation done without airsep/oxygen cylinderin severely depressed baby,but respond of resuscitation is also good,but a little longer duration of resuscitation time consuming.
March 16, 201014 yr comment_3005 In Canada, our Neonatal Resuscitation Guidelines say to start at 21%. We do this for all our babies (primarily premature infants ranging 420 - ~1200g), although depending on the neonatologist, we may not stay on r/a for the full 90 seconds recommended before increasing (usually to 30%, then 40% etc.). Overall I'd say we are pretty cautious, only looking to increase FiO2 if sats are consistently less than 80% with good ventilation. We are able to stay either on r/a or less than 40% with most of our babies, even before we get the surfactant (bLES) into the babies. All of our resuscitation warmers, and every NICU bedside has a blender to control FiO2 to the baggers.
April 14, 201014 yr comment_3129 depend if the baby is term or preterm. There is a evidence that in term babies to beginn with air and in preterms with 30% O2 Saugstad in many articles discuss about this problem.
April 28, 201014 yr In our unit we use 100% o2 for term baby and <100% for preterm baby ,but 40% o2 is logic and if the baby not improved after 60-90 sec the use of 100% o2 is needed.
May 19, 201014 yr We prefer to start resuscitation at 21% and increase the FiO2 if necessary thereafter.
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