Resuscitation of the newborn with room air or oxygen?

The International Liaison Committee on Resuscitation (ILCOR) and American Heart Association/American Academy of Pediatrics (AHA/AAP) in their new guidelines hoth advocate the Lise of 100% O2 for newborn resııscitation. The International Guidelines 2000 state: "100% oxygen has been u.scd traditionally for rapid reversal of hypoxia. Although biochemical and preliminary clinical evidence suggest that lower inspired oxygen concentrations may be useful in some settings, data is insufticient to justify a change from the recommendation that 100% oxygen be used if assisted ventilation is required. If sııpplemental oxygen is unavailable and positive ventilation is required, use room air". The oxygen source is recommended to be al least 5 L/ min, and the oxygen should be held close to the race to maximize the inhaled concentration. And it is underlined that self-inflating bags often will not passively deliver sufficient oxygen flow. Free flow oxygen could be delivered through a facemask and a flowinflating bag, an oxygen mask, or a hand cupped around oxygen tubing. The goal of supplemental oxygen administration should be nortnoxia. The majör change of the points dealing with oxygen since the 1992 recommendations is that the new guidelines explicitly state that room air should be used if oxygen is not available. This is an important statement since in some places resuscitation seems occassionally not to be initiated at all if supplemental oxygen is not present. Furthermore, the sentences in the 1992 AHA recommendations indicating that brief exposure to hyperoxia during resuscitation is not harmful, have been removed.