0000000000083829
AUTHOR
Marta Aguar
Consequences of neonatal resuscitation with supplemental oxygen.
There has been considerable controversy surrounding the optimal inspired oxygen concentration for resuscitation of term and preterm infants. We have developed a rat pup model to quantify both physiologic and biochemical parameters associated with normoxic vs. hyperoxic resuscitation. We have confirmed existing human data that hyperoxic resuscitation of rat pups is associated with a significant delay in onset of spontaneous respiratory efforts. Both 40% and 100% inspired oxygen delayed onset of respiratory activity when compared to 21% oxygen. We have also documented, in the rat pup model, that hyperoxic resuscitation is associated with reduced levels of glutathione at 24 hours post resuscit…
Human milk enhances antioxidant defenses against hydroxyl radical aggression in preterm infants
Background: Preterm infants endowed with an immature antioxidant defense system are prone to oxidative stress. Hydroxyl radicals are very aggressive reactive oxygen species that lack specific antioxidants. These radicals cannot be measured directly, but oxidation byproducts of DNA or phenylalanine in urine are reliable markers of their activity. Human milk has a higher antioxidant capacity than formula. Objective: We hypothesized that oxidative stress associated with prematurity could be diminished by feeding human milk. Design: We recruited a cohort of stable preterm infants who lacked perinatal conditions associated with oxidative stress; were not receiving prooxidant or antioxidant drugs…
Target oxygen levels in preterm neonates
To achieve postnatal adaptation newly born infant need to aerate the lungs, reduce pulmonary vascular resistance, and initiate oxygen and carbon dioxide exchange. The cornerstone of newborn resuscitation resides therefore in the establishment of a functional residual capacity and an adequate oxygenation. Recent guidelines have established guidelines concerning oxygen supplementation in preterm infants in the delivery room (DR); however, they are vague and unspecific. Herewith, we will address available information regarding the use of oxygen supplementation in the DR in preterm infants to satisfactorily overcome postnatal adaptation. Introduction: Resuscitation of the newborn is considered …
Antenatal Steroids and Antioxidant Enzyme Activity in Preterm Infants: Influence of Gender and Timing
Antenatal steroids have improved the survival of preterm infants; however, the mechanism of action is not fully understood. We aimed to establish an association between antenatal steroids and antioxidant activity and postnatal oxidative stress. In a prospective cohort study, extremely preterm neonates receiving antenatal steroids (CORT) or not (NOCORT) were enrolled. An association between antenatal steroids and activities of antioxidant enzymes and glutathione cycle enzymes in cord blood was found. In addition, reduced oxidative stress (GSH/GSSG ratio, CORT vs. NOCORT, 35.68 + or - 12.20 vs. 28.38 + or - 9.92; p < 0.01) and, decreased oxidation of proteins (ortho-tyrosine/phenylalanine rat…