氧氣於新生兒急救之運用

Resuscitation of Newborn Infants With Oxygen

正常生理過程所產生的代謝產物經過氧化後，可能會產生有毒性的游離基。當面臨窒息的情況下，身體內會產生更多的代謝產物，當血液再度灌流時，使用100%氧氣急救者往往血中氧氣濃度比使用21%氧氣者為高，血中氧氣濃度愈高，也會因氧化作用更強而產生更多有毒性的游離基，對細胞造成毒害。而且經由研究顯示，急救時使用21%的氧氣並不比傳統使用100%氧氣方式者效果差，之後的副作用也較少。不過， 研究結果雖然是這樣，目前實證研究仍猶嫌不足，因此，目前仍宜遵照2000版小兒心臟醫學會的建議，急救時使用100%氧氣，之後視情況調降氧氣濃度。

The metabolites of reoxygenation accumulate as toxic free radicals during physiological reactions. During an episode of asphyxia, 100% oxygen rather than 21% oxygen is usually used for resuscitation. Excessive free radicals and cell injury may be produced during reoxygenation following the hypoxic event. Prior research has shown that resuscitation with room air (21% oxygen) may be equally effective as 100% oxygen. The side effects are also less with room air. However, evidence-based studies on this topic are limited. It is, therefore, more appropriate to follow the recommendation of Neonatal Resuscitation Program that 100% oxygen should be used during neonatal resuscitation and the oxygen concentration should be adjusted according to the different condition of individual infants.