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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.

Hellström-Westas, Lena LU ; Forsblad, Kristina ; Sjors, Gunnar ; Saugstad, Ola Didrik ; Björklund, Lars LU ; Marsal, Karel LU and Källén, Karin LU (2006) In Pediatrics 118(6). p.1798-1804
Abstract
OBJECTIVES. The aim of this study was to evaluate whether a resuscitation strategy based on administration of 40% oxygen influences mortality rates and rates of improvement in 5-minute Apgar scores, compared with a strategy based on 100% oxygen administration. METHODS. A population-based study evaluated data from 4 Swedish perinatal level III centers during the period of 1998 to 2003. During this period, the centers used either of 2 resuscitation strategies (initial oxygen administration of 40% or 100%). Live-born, singleton, term infants with 1-minute Apgar scores of < 4, with a birth weight appropriate for gestational age, and without major malformations were included in the study (n = 1223). RESULTS. Infants born in hospitals using a... (More)
OBJECTIVES. The aim of this study was to evaluate whether a resuscitation strategy based on administration of 40% oxygen influences mortality rates and rates of improvement in 5-minute Apgar scores, compared with a strategy based on 100% oxygen administration. METHODS. A population-based study evaluated data from 4 Swedish perinatal level III centers during the period of 1998 to 2003. During this period, the centers used either of 2 resuscitation strategies (initial oxygen administration of 40% or 100%). Live-born, singleton, term infants with 1-minute Apgar scores of < 4, with a birth weight appropriate for gestational age, and without major malformations were included in the study (n = 1223). RESULTS. Infants born in hospitals using a 40% oxygen strategy had a more rapid Apgar score increase than did infants born in hospitals using a 100% oxygen strategy; however, no difference remained at 10 minutes. The mean Apgar score increased from 2.01 at 1 minute to 6.74 at 5 minutes in the 2 hospitals initiating resuscitation with 40% oxygen, compared with 2.01 to 6.38 in the 2 hospitals using 100% oxygen, with a mean difference in Apgar score increases of 0.36. At 5 minutes, 44.3% of infants born in the hospitals using 100% oxygen had an Apgar score of < 7, compared with 34.0% of infants at the hospitals using 40% oxygen. At 10 minutes, the mean Apgar scores were 8.16 at the hospitals using 40% oxygen and 8.07 at the hospitals using 100% oxygen. There were no significant differences in rates of neonatal death, hypoxic ischemic encephalopathy, or seizures in relation to the 2 oxygen strategies. CONCLUSION. Severely depressed term infants born in hospitals initiating resuscitation with 40% oxygen had earlier Apgar score recovery than did infants born in hospitals using a 100% oxygen strategy. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Resuscitation: methods, Registries, Newborn, Infant, Humans, Apgar Score, Oxygen: administration & dosage, Diseases: therapy, Severity of Illness Index, Sweden, Time Factors
in
Pediatrics
volume
118
issue
6
pages
1798 - 1804
publisher
American Academy of Pediatrics
external identifiers
  • wos:000242478900076
  • scopus:33947149592
  • pmid:17142501
ISSN
1098-4275
DOI
10.1542/peds.2006-0102
language
English
LU publication?
yes
id
477eb812-4345-4555-8983-3ea5cadeba74 (old id 164198)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17142501&dopt=Abstract
date added to LUP
2016-04-01 16:23:33
date last changed
2021-10-06 01:02:06
@article{477eb812-4345-4555-8983-3ea5cadeba74,
  abstract     = {OBJECTIVES. The aim of this study was to evaluate whether a resuscitation strategy based on administration of 40% oxygen influences mortality rates and rates of improvement in 5-minute Apgar scores, compared with a strategy based on 100% oxygen administration. METHODS. A population-based study evaluated data from 4 Swedish perinatal level III centers during the period of 1998 to 2003. During this period, the centers used either of 2 resuscitation strategies (initial oxygen administration of 40% or 100%). Live-born, singleton, term infants with 1-minute Apgar scores of &lt; 4, with a birth weight appropriate for gestational age, and without major malformations were included in the study (n = 1223). RESULTS. Infants born in hospitals using a 40% oxygen strategy had a more rapid Apgar score increase than did infants born in hospitals using a 100% oxygen strategy; however, no difference remained at 10 minutes. The mean Apgar score increased from 2.01 at 1 minute to 6.74 at 5 minutes in the 2 hospitals initiating resuscitation with 40% oxygen, compared with 2.01 to 6.38 in the 2 hospitals using 100% oxygen, with a mean difference in Apgar score increases of 0.36. At 5 minutes, 44.3% of infants born in the hospitals using 100% oxygen had an Apgar score of &lt; 7, compared with 34.0% of infants at the hospitals using 40% oxygen. At 10 minutes, the mean Apgar scores were 8.16 at the hospitals using 40% oxygen and 8.07 at the hospitals using 100% oxygen. There were no significant differences in rates of neonatal death, hypoxic ischemic encephalopathy, or seizures in relation to the 2 oxygen strategies. CONCLUSION. Severely depressed term infants born in hospitals initiating resuscitation with 40% oxygen had earlier Apgar score recovery than did infants born in hospitals using a 100% oxygen strategy.},
  author       = {Hellström-Westas, Lena and Forsblad, Kristina and Sjors, Gunnar and Saugstad, Ola Didrik and Björklund, Lars and Marsal, Karel and Källén, Karin},
  issn         = {1098-4275},
  language     = {eng},
  number       = {6},
  pages        = {1798--1804},
  publisher    = {American Academy of Pediatrics},
  series       = {Pediatrics},
  title        = {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.},
  url          = {http://dx.doi.org/10.1542/peds.2006-0102},
  doi          = {10.1542/peds.2006-0102},
  volume       = {118},
  year         = {2006},
}