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Preterm Resuscitation With Low Oxygen Causes Less Oxidative Stress, Inflammation, and Chronic Lung Disease
- Source :
- Pediatrics. 124:e439-e449
- Publication Year :
- 2009
- Publisher :
- American Academy of Pediatrics (AAP), 2009.
-
Abstract
- OBJECTIVE: The goal was to reduce adverse pulmonary adverse outcomes, oxidative stress, and inflammation in neonates of 24 to 28 weeks of gestation initially resuscitated with fractions of inspired oxygen of 30% or 90%. METHODS: Randomized assignment to receive 30% (N = 37) or 90% (N = 41) oxygen was performed. Targeted oxygen saturation values were 75% at 5 minutes and 85% at 10 minutes. Blood oxidized glutathione (GSSG)/reduced glutathione ratio and urinary o-tyrosine, 8-oxo-dihydroxyguanosine, and isoprostane levels, isofuran elimination, and plasma interleukin 8 and tumor necrosis factor α levels were determined. RESULTS: The low-oxygen group needed fewer days of oxygen supplementation (6 vs 22 days; P < .01) and fewer days of mechanical ventilation (13 vs 27 days; P < .01) and had a lower incidence of bronchopulmonary dysplasia at discharge (15.4% vs 31.7%; P < .05). GSSG/reduced glutathione × 100 ratios at day 1 and 3 were significantly higher in the high-oxygen group (day 1: high-oxygen group: 13.36 ± 5.25; low-oxygen group: 8.46 ± 3.87; P < .01; day 3: high-oxygen group: 8.87 ± 4.40; low-oxygen group: 6.97 ± 3.11; P < .05). Urinary markers of oxidative stress were increased significantly in the high-oxygen group, compared with the low-oxygen group, in the first week after birth. GSSG levels on day 3 and urinary isofuran, o-tyrosine, and 8-hydroxy-2′-deoxyguanosine levels on day 7 were correlated significantly with development of chronic lung disease. CONCLUSIONS: Resuscitation of preterm neonates with 30% oxygen causes less oxidative stress, inflammation, need for oxygen, and risk of bronchopulmonary dysplasia.
- Subjects :
- Male
medicine.medical_specialty
Resuscitation
Isoprostane
Infant, Premature, Diseases
medicine.disease_cause
Gastroenterology
chemistry.chemical_compound
Isofuran
Internal medicine
medicine
Humans
Prospective Studies
Bronchopulmonary Dysplasia
Oxygen saturation (medicine)
Inflammation
business.industry
Infant, Newborn
Oxygen Inhalation Therapy
Glutathione
medicine.disease
Oxygen
Oxidative Stress
Bronchopulmonary dysplasia
chemistry
Anesthesia
Pediatrics, Perinatology and Child Health
Glutathione disulfide
Female
business
Infant, Premature
Oxidative stress
Subjects
Details
- ISSN :
- 10984275 and 00314005
- Volume :
- 124
- Database :
- OpenAIRE
- Journal :
- Pediatrics
- Accession number :
- edsair.doi.dedup.....1bb6c2bb8167dafa498127353fca8381