***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE : To determine whether a limited oxygen strategy ( LOX ) versus a high oxygen strategy ( HOX ) during delivery room resuscitation decreases oxidative stress in preterm neonates . METHODS : A r and omized trial of neonates of 24 to 34 weeks ’ gestational age ( GA ) who received resuscitation was performed . LOX neonates received room air as the initial resuscitation gas , and fraction of inspired oxygen ( Fio2 ) was adjusted by 10 % every 30 seconds to achieve target preductal oxygen saturations ( Spo2 ) as described by the 2010 Neonatal Resuscitation Program guidelines . HOX neonates received 100 % O2 as initial resuscitation gas , and Fio2 was adjusted by 10 % to keep preductal Spo2 at 85 % to 94 % . Total hydroperoxide ( TH ) , biological antioxidant potential ( BAP ) , and the oxidative balance ratio ( BAP/TH ) were analyzed in cord blood and the first hour of life . Secondary outcomes included delivery room interventions , respiratory support on NICU admission , and short-term morbidities . RESULTS : Forty-four LOX ( GA : 30 ± 3 weeks ; birth weight : 1678 ± 634 g ) and 44 HOX ( GA : 30 ± 3 weeks ; birth weight : 1463 ± 606 g ) neonates were included . LOX  decreased integrated excess oxygen ( ∑Fio2 × time [ min ] ) in the delivery room compared with HOX ( 401 ± 151 vs 662 ± 249 ; P < .01 ) . At 1 hour of life , BAP/TH was 60 % higher for LOX versus HOX neonates ( 13 [ 9–16 ] vs 8 [ 6–9 ] ) µM/U.CARR , P < .01 ) . LOX  decreased ventilator days ( 3 [ 0–64 ] vs 8 [ 0–96 ] ; P < .05 ) and reduced the incidence of bronchopulmonary dysplasia ( 7 % vs 25 % ; P < .05 ) . CONCLUSIONS : LOX is feasible and results in less oxygen exposure , lower oxidative stress , and decreased respiratory morbidities and thus is a reasonable alternative for resuscitation of preterm neonates in the delivery room OBJECTIVE : To determine if practice s related to the use of pulse oximetry in the first 2 weeks following birth and after 2 weeks of age have a relationship to the rate of retinopathy of prematurity ( ROP ) and retinal ablation surgery in infants ≤1500 g. STUDY DESIGN : A question naire was mailed in July 2001 to 318 neonatal intensive care units ( NICUs ) in the United States and information was collected regarding SpO2 guidelines and the rate of both severe ROP and retinal ablation surgery . RESULTS : A total of 142 surveys were returned ( 45 % ) . In all , 87 % of the NICUs had SpO2 guidelines , and 60 % of these centers maintained a different range of SpO2 for infants ≤ or > 2 weeks of age . The range of SpO2 was 82 to 100 % with an average minimum ( min ) and maximum ( max ) of 89 and 95 % , respectively . In the NICUs with an SpO2 max of > 98 % in the first 2 weeks following birth , the rate of retinal ablation surgery was 5.5 vs 3 % in those units with a max SpO2 > 98 % ( p<0.05 ) . After 2 weeks of age , the rate of retinal ablation surgery was 3.3 % when max SpO2 was > 92 vs 1.3 % when the max SpO2 was ≤92 % ( p<0.00001 ) . The rate of ≥stage 3 ROP after 2 weeks of age was 5.5 % when max SpO2 was > 92 vs 2.4 % when max SpO2 was ≤92 % ( p<0.0005 ) . CONCLUSION : NICUs in the US today have a wide range of SpO2 guidelines . The results of this survey show a “ gradient of risk ” towards less retinal ablation surgery when the max SpO2 is < 98 % in the first 2 weeks following birth ( p<0.05 ) . There was a statistically significant lower rate of ≥stage 3 ROP and retinal ablation surgery when the max SpO2 was ≤92 % after the first 2 weeks of age . A r and omized , controlled trial is needed to establish a safe upper limit of SpO2 in the premature infant at risk for developing ROP BACKGROUND Previous studies have suggested that the incidence of retinopathy is lower in preterm infants with exposure to reduced levels of oxygenation than in those exposed to higher levels of oxygenation . However , it is unclear what range of oxygen saturation is appropriate to minimize retinopathy without increasing adverse outcomes . METHODS We performed a r and omized trial with a 2-by-2 factorial design to compare target ranges of oxygen saturation of 85 to 89 % or 91 to 95 % among 1316 infants who were born between 24 weeks 0 days and 27 weeks 6 days of gestation . The primary outcome was a composite of severe retinopathy of prematurity ( defined as the presence of threshold retinopathy , the need for surgical ophthalmologic intervention , or the use of bevacizumab ) , death before discharge from the hospital , or both . All infants were also r and omly assigned to continuous positive airway pressure or intubation and surfactant . RESULTS The rates of severe retinopathy or death did not differ significantly between the lower-oxygen-saturation group and the higher-oxygen-saturation group ( 28.3 % and 32.1 % , respectively ; relative risk with lower oxygen saturation , 0.90 ; 95 % confidence interval [ CI ] , 0.76 to 1.06 ; P=0.21 ) . Death before discharge occurred more frequently in the lower-oxygen-saturation group ( in 19.9 % of infants vs. 16.2 % ; relative risk , 1.27 ; 95 % CI , 1.01 to 1.60 ; P=0.04 ) , whereas severe retinopathy among survivors occurred less often in this group ( 8.6 % vs. 17.9 % ; relative risk , 0.52 ; 95 % CI , 0.37 to 0.73 ; P<0.001 ) . There were no significant differences in the rates of other adverse events . CONCLUSIONS A lower target range of oxygenation ( 85 to 89 % ) , as compared with a higher range ( 91 to 95 % ) , did not significantly decrease the composite outcome of severe retinopathy or death , but it result ed in an increase in mortality and a substantial decrease in severe retinopathy among survivors . The increase in mortality is a major concern , since a lower target range of oxygen saturation is increasingly being advocated to prevent retinopathy of prematurity . ( Clinical Trials.gov number , NCT00233324 . 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 : R and omized 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 α 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 × 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 OBJECTIVE To assess whether an oxygen saturation ( Spo2 ) target of 85%-89 % compared with 91%-95 % reduced the incidence of the composite outcome of death or major disability at 2 years of age in infants born at < 28 weeks ' gestation . STUDY DESIGN A total 340 infants were r and omized to a lower or higher target from < 24 hours of age until 36 weeks ' gestational age . Blinding was achieved by targeting a displayed Spo2 of 88%-92 % using a saturation monitor offset by ±3 % within the range 85%-95 % . True saturations were displayed outside this range . Follow-up at 2 years ' corrected age was by pediatric examination and formal neurodevelopmental assessment . Major disability was gross motor disability , cognitive or language delay , severe hearing loss , or blindness . RESULTS The primary outcome was known for 335 infants with 33 using surrogate language information . Targeting a lower compared with a higher Spo2 target range had no significant effect on the rate of death or major disability at 2 years ' corrected age ( 65/167 [ 38.9 % ] vs 76/168 [ 45.2 % ] ; relative risk 1.15 , 95 % CI 0.90 - 1.47 ) or any secondary outcomes . Death occurred in 25 ( 14.7 % ) and 27 ( 15.9 % ) of those r and omized to the lower and higher target , respectively , and blindness in 0 % and 0.7 % . CONCLUSIONS Although there was no benefit or harm from targeting a lower compared with a higher saturation in this trial , further information will become available from the prospect ively planned meta- analysis of this and 4 other trials comprising a total of nearly 5000 infants The relation between PaO2 and retrolental fibroplasia ( RLF ) was studied prospect ively in 719 premature infants born in or treated in the intensive care units of a group of university hospitals .  Blood gas studies  were performed on 589 of these infants , 66 of whom had a diagnosis of RLF ; in 27 of these 66 , some grade of mostly nonblinding cicatricial disease developed . The frequency of RLF was highest among infants of lowest birth weight . A multivariate statistical method was used to analyze simultaneously the effect of possible etiologic factors associated with RLF . The occurrence of RLF was found to be unrelated to PaO2 , as determined by the limited information available from intermittent sampling . RLF is associated with concentration of oxygen administered in the lightest birth weight group , but the strongest association , aside from birth weight , was with time in oxygen . None of the other variables involving blood chemical values appeared to be associated with RLF . The severity of cicatricial RLF is clearly greater in infants weighing less than 1,200 g at birth . Conservative administration of oxygen may have been responsible for failure to demonstrate quantitative association between PaO2 levels and disease . Agreement between the observed and predicted numbers of infants with RLF demonstrate the strength of the multivariate technique employed in making the statistical analyses AIMS : To determine if decreasing arterial blood saturation from 95 % to 90 % could cause vasoconstriction of the pulmonary vasculature and dilatation of a patent ductus arteriosus in preterm newborn infants with respiratory distress syndrome ( RDS ) . METHODS : Doppler echocardiographic studies were compared at 95 % and 90 % pulse oxygen saturation ( SpO2 ) in 13 preterm infants aged 61.7 ( 4.3 ) hours with RDS and Doppler echocardiographic evidence of tricuspid regurgitation . RESULTS : The mean (SD)Doppler echocardiographic indices determined at 95 % were heart rate ( 146 ( 3.60 ) beats per minute ) , acceleration time of the velocity wave forms of the pulmonary artery ( PAAT ) ( 51.8 ( 2.5 ) milliseconds ) , ratio of PAAT to right ventricular ejection time ( ET ) (  
    Output:
    
In extremely preterm infants , targeting lower ( 85 % to 89 % ) SpO₂ compared to higher ( 91 % to 95 % ) SpO₂ had no significant effect on the composite outcome of death or major disability or on major disability alone , including blindness , but increased the average risk of mortality by 28 per 1000 infants treated .