Clinicians In 25 Countries Prefer To Use Lower Levels Of Oxygen To Resuscitate Preterm Infants At Birth

AimThis study determined current international clinical practice and opinions regarding initial fractional inspired oxygen (FiO(2)) and pulse oximetry (SpO(2)) targets for delivery room resuscitation of preterm infants of less than 29 weeks of gestation.MethodsAn online survey was disseminated to neonatal clinicians via established professional clinical networks using a web-based survey programme between March 9 and June 30, 2015.ResultsOf the 630 responses from 25 countries, 60% were from neonatologists. The majority (77%) would target SpO(2) between the 10th to 50th percentiles values for full-term infants. The median starting FiO(2) was 0.3, with Japan using the highest (0.4) and the UK using the lowest (0.21). New Zealand targeted the highest SpO(2) percentiles (median 50%). Most respondents agreed or did not disagree that a trial was required that compared the higher FiO(2) of 0.6 (83%), targeting the 50th SpO(2) percentile (60%), and the lower FiO(2) of 0.21 (80%), targeting the 10th SpO(2) percentile (78%). Most (65%) would join this trial. Many considered that evidence was lacking and further research was needed.ConclusionClinicians currently favour lower SpO(2) targets for preterm resuscitation, despite acknowledging the lack of evidence for benefit or harm, and 65% would join a clinical trial.