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Oxygen Administration and Monitoring Flashcards

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  1. What initial concentration of oxygen is recommended when starting positive-pressure ventilation for a term infant during neonatal resuscitation?

    Answer: 21% oxygen (room air)

    NRP 8th edition recommends starting PPV with 21% oxygen (room air) for term infants, adjusting the FiO2 based on pulse oximetry targets.

  2. Where should the pulse oximetry probe be placed during neonatal resuscitation to measure preductal oxygen saturation?

    Answer: Right hand or wrist

    Preductal SpO2 is measured on the right hand or wrist, which receives blood from the right subclavian artery — before the ductus arteriosus joins the aorta — giving a more accurate reflection of cerebral oxygenation.

  3. What is the target preductal SpO2 at 5 minutes of life for a newborn undergoing resuscitation, according to NRP guidelines?

    Answer: 80–85%

    The NRP target SpO2 at 5 minutes of life is 80–85%, reflecting the normal physiological rise from the fetal baseline as the pulmonary circulation opens and ventilation is established.

  4. Why is 100% oxygen harmful in neonatal resuscitation, and what specific risk does it pose?

    Answer: 100% oxygen generates excess reactive oxygen species (free radicals), causing oxidative injury to organs including the brain and lungs

    Hyperoxia generates excess reactive oxygen species (free radicals), leading to oxidative stress that can injure immature tissues including the brain, lungs, and retina. This is particularly harmful in preterm infants whose antioxidant defenses are underdeveloped.

  5. What should the resuscitation team do if a newborn's SpO2 is consistently above the NRP target range during resuscitation?

    Answer: Wean the supplemental oxygen (FiO2) to bring SpO2 back into the target range

    If SpO2 exceeds the NRP target range, supplemental oxygen should be decreased (FiO2 weaned), since hyperoxia is harmful. The goal is to maintain SpO2 within the physiological target range, not maximize it.

  6. For a preterm infant less than 35 weeks gestation requiring resuscitation, what starting oxygen concentration does NRP recommend?

    Answer: 21–30%

    For preterm infants less than 35 weeks gestation, NRP recommends starting with 21–30% oxygen and titrating based on SpO2 targets, balancing the risk of hypoxia and hyperoxia in the immature lung.