Preterm Resuscitation With Low Oxygen Causes Less Oxidative Stress, Inflammation, and Chronic Lung Disease
Preterm Resuscitation With Low Oxygen Causes Less Oxidative Stress, Inflammation, and Chronic Lung Disease
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DOI：
10.1542/peds.2009-0434
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发表时间：
2009-09-01
期刊：
影响因子：
8
通讯作者：
Asensi, Miguel A.
中科院分区：
文献类型：
--
作者：
Vento, Maximo;Moro, Manuel;Asensi, Miguel A.
目的：目的是减少妊娠24 - 28周的新生儿在初始复苏时吸入氧气分数为30%或90%.METHODS：随机分配接受30%（N = 37）或90%（N = 41）氧气的不良肺部不良结局、氧化应激和炎症。5分钟时目标氧饱和度值为75%，10分钟时为85%。测定血中氧化型谷胱甘肽（GSSG）/还原型谷胱甘肽比值、尿中o-酪氨酸、8-氧代-二羟基鸟苷和异前列烷水平、异呋喃清除率、血浆白细胞介素8和肿瘤坏死因子α水平（6 vs 22天; P < .01）和机械通气天数更少（13 vs 27天; P < .01），出院时支气管肺发育不良的发生率更低（15.4% vs 31.7%; P < .05）。高氧组第1天和第3天的GSSG/还原型谷胱甘肽x100比值显著高于对照组，（第1天：高氧组：13.36 ± 5.25;低氧组：8.46 ± 3.87; P <0.01;第3天：高氧组：8.87 ± 4.40;低氧组：6.97 ± 3.11; P < .05）。出生后第一周，高氧组与低氧组相比，尿液氧化应激标志物显著增加。GSSG水平在第3天和尿异呋喃，o-酪氨酸，和8-羟基-2 '-脱氧鸟苷水平在第7天与慢性肺diseases.Conclusions的发展显着相关：早产儿复苏与30%的氧气会导致氧化应激，炎症，需要氧气，和支气管肺发育不良的风险。儿科2009; 124：e439-e449
OBJECTIVE: The goal was to reduce adverse pulmonary adverse outcomes, oxidative stress, and inflammation in neonates of 24 to 28 weeks of gestation initially resuscitated with fractions of inspired oxygen of 30% or 90%.METHODS: Randomized assignment to receive 30% (N = 37) or 90% (N = 41) oxygen was performed. Targeted oxygen saturation values were 75% at 5 minutes and 85% at 10 minutes. Blood oxidized glutathione (GSSG)/reduced glutathione ratio and urinary o-tyrosine, 8-oxo-dihydroxyguanosine, and isoprostane levels, isofuran elimination, and plasma interleukin 8 and tumor necrosis factor alpha levels were determined.RESULTS: The low-oxygen group needed fewer days of oxygen supplementation (6 vs 22 days; P < .01) and fewer days of mechanical ventilation (13 vs 27 days; P < .01) and had a lower incidence of bronchopulmonary dysplasia at discharge (15.4% vs 31.7%; P < .05). GSSG/reduced glutathione x 100 ratios at day 1 and 3 were significantly higher in the high-oxygen group (day 1: high-oxygen group: 13.36 +/- 5.25; low-oxygen group: 8.46 +/- 3.87; P < .01; day 3: high-oxygen group: 8.87 +/- 4.40; low-oxygen group: 6.97 +/- 3.11; P < .05). Urinary markers of oxidative stress were increased significantly in the high-oxygen group, compared with the low-oxygen group, in the first week after birth. GSSG levels on day 3 and urinary isofuran, o-tyrosine, and 8-hydroxy-2'-deoxyguanosine levels on day 7 were correlated significantly with development of chronic lung disease.CONCLUSIONS: Resuscitation of preterm neonates with 30% oxygen causes less oxidative stress, inflammation, need for oxygen, and risk of bronchopulmonary dysplasia. Pediatrics 2009; 124: e439-e449