Advertisement

Oxygen Therapy

Chapter
  1. I.
    Introduction
    1. A.

      “The clinician must bear in mind that oxygen is a drug and must be used in accordance with well recognized pharmacologic principles; i.e., since it has certain toxic effects and is not completely harmless (as widely believed in clinical circles) it should be given only in the lowest dosage or concentration required by the particular patient.” [Julius Comroe, 1945].

       
    2. B.

      Oxygen is the most commonly used therapy in neonatal intensive care units, and ocular oxygen toxicity in newborns (cicatricial retinopathy of prematurity, ROP) was first described more than 50 years ago.

       
    3. C.

      The ultimate aim of oxygen therapy is to achieve adequate tissue oxygenation, but without creating oxygen toxicity and oxidative stress.

       
     
  2. II.
    Physiological considerations
    1. A.
      Tissue oxygenation depends upon:
      1. 1.

        Fractional-inspired oxygen (FiO2).

         
      2. 2.

        Gas exchange mechanism within the lungs.

         
      3. 3.

        Cardiac output.

         
      4. 4.

        Oxygen carrying capacity of the blood. Approximately 97% of oxygen transported...

Keywords

Oxygen Tension Pulse Oximetry Oxygen Therapy High Oxygen Affinity Fetal Oxygen 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. Askie LM, Henderson-Smart DJ, Irwig L, Simpson JM. Oxygen saturation targets and outcomes in extremely preterm infants. N Engl J Med. 2003;349:959–67.PubMedCrossRefGoogle Scholar
  2. Brockway J, Hay WW. Prediction of arterial partial pressure of oxygen with pulse oxygen saturation measurements. J Pediatr. 1998;133:63–6.PubMedCrossRefGoogle Scholar
  3. Delivoria-Papadopoulos M, McGowan JE. Oxygen transport and delivery. In: Polin RA, Fox WW, Abman SH, editors. Fetal and neonatal physiology. Philadelphia: Saunders; 2004.Google Scholar
  4. Saugstad OD. Bronchpulmonary dysplasia – oxidative stress and antioxidants. Semin Neonatol. 2003;8:39–49.PubMedCrossRefGoogle Scholar
  5. Silverman WA. A cautionary tale about supplemental oxygen: the albatross of neonatal medicine. Pediatrics. 2004;113:394–6.PubMedCrossRefGoogle Scholar
  6. Silverman WA. Retrolental fibroplasias: a modern parable. New York: Grune & Stratton; 1980.Google Scholar
  7. Smith LE. Pathogenesis of retinopathy of prematurity. Semin Neonatol. 2003;8:469–73.PubMedCrossRefGoogle Scholar
  8. Stop ROP. Investigators. Supplemental therapeutic oxygen for prethreshold retinopathy of prematurity (STOP-ROP), a randomized controlled trial.1: primary outcomes. Pediatrics. 2000;105:295–310.CrossRefGoogle Scholar
  9. SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network, Carlo WA, Finer NN, Walsh MC, et al. Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med. 2010;362:1959–1969.Google Scholar
  10. Tin W, Gupta S. Optimal levels of oxygenation in preterm infants: impact on outcomes. In: Bancalari E, Polin R, editors. Questions and controversies in neonatology series: pulmonary volume. Philadelphia: Elsevier; 2008.Google Scholar
  11. Tin W, Gupta S. Optimum oxygen therapy in preterm babies. Arch Dis Child. 2007;92:F143–147.Google Scholar
  12. Tin W, Wariyar U. Giving small babies oxygen: 50 years of uncertainty. Semin Neonatol. 2002;7:361–7.PubMedCrossRefGoogle Scholar
  13. Weis CM, Cox CA, Fox WW. Oxygen therapy. In: Spitzer AR, editor. Intensive care of the fetus and newborn. St. Louis: Mosby; 1996.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Neonatal MedicineThe James Cook University HospitalMiddlesbroughUK

Personalised recommendations