Oxygen for the Newborn: Friend or Foe?

Oxygen supplementation is widely used in neonatal care, however, it can also cause toxic effects if not used properly. Therefore, it appears crucial to find a balance in oxygen administration to avoid damage as a consequence of its insufficient or excessive use. Oxygen toxicity is mainly due to the production of oxygen radicals, molecules normally produced in humans and involved in a myriad of physiological reactions. In the neonatal period, an imbalance between oxidants and antioxidant defenses, the so-called oxidative stress, might occur, causing severe pathological consequences. In this review, we focus on the mechanisms of the production of oxygen radicals and their physiological functions in determining a set of diseases grouped together as free radical diseases in the neonate. In addition, we describe the evolution of the oxygenation target recommendations during neonatal resuscitation and post-stabilization phases with the aim to define the best oxygen administration according to the newest evidence.

Automated summary

Oxygen supplementation is widely used in neonatal care, but can cause toxic effects if not used properly. Finding a balance in oxygen administration is crucial to avoid damage from insufficient or excessive use. Oxygen toxicity is mainly due to the production of oxygen radicals, which can lead to severe pathological consequences in the neonate. This review focuses on the mechanisms of oxygen radical production and their physiological functions in neonatal free radical diseases, as well as the evolution of oxygenation target recommendations for neonatal resuscitation and post-stabilization phases.