Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Sharon Barton

Committee Member

Vicki Hines-Martin

Author's Keywords

oxygen saturation, bronchopulmonary dysplasia, preterm infant, delivery room resuscitation, limited versus high oxygen strategy, initial fraction of oxygen (Fi02), oxidative stress


Recent evidence confirms the first 10 minutes after birth are extremely important for the short and long-term outcomes of premature infants, specifically for the risk of developing bronchopulmonary dysplasia (BPD). Neonates who are resuscitated with 100% oxygen concentration in the delivery room during the first 10 minutes after birth have a 35% chance to develop BPD (Vento, 2009). Neonates who are resuscitated with lower oxygen levels in the first 10 minutes of life have a 15% chance of developing BPD. BPD is diagnosed when a neonate requires oxygen at ³28 postnatal days or at 36 weeks corrected gestational age, along with clinical symptoms of severe respiratory disease, such as increased work of breath, tachypnea, opacities throughout bilateral lung fields via chest radiograph, and necessary supplemental oxygen (Wambach & Hamvas, 2015). BPD is the leading cause of morbidity and mortality during the first year of life in the developed world (Zysman-Colman et al., 2013). Neonates with BPD have shorter life spans due to airway obstruction, reactive airways, and emphysema. Neonates with BPD have a 50% increased chance of rehospitalization during the first year of life, as well as significant cardiovascular adverse effects and subsequent neurodevelopment delays (Kair, Leonard, & Anderson, 2012). This project was implemented in the University of Louisivlle (ULH) Neonatal Intensive Care Unit (NICU) with data gathered from the Vermont Oxford Network (VON) database on neonates born between 24-32 weeks gestation at ULH to identify if highly concentrated oxygen use during initial resuscitation occurred at a higher rate in infants who subsequently had a diagnosis of bronchopulmonary dysplasia (BPD). While the literature contains evidence that high versus low oxygen concentration, during the first 10 minutes of life leads to outcomes of BPD, this review was undertaken to determine the current initial resuscitation practice in the ULH NICU and neonatal outcomes of BPD.

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