Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Randomized Trial of a Limited Versus Traditional Oxygen Strategy During Resuscitation in Premature Newborns
Brief Summary: Preterm infants are born with immature lungs and often require help with breathing shortly after birth. This traditionally involves administering 100% oxygen. Unfortunately, delivery of high oxygen concentrations leads to the production of free radicals that can injure many organ systems. Term and near-term newborns deprived of oxygen during or prior to birth respond as well or better to resuscitation with room air (21% oxygen) compared to 100% oxygen. However, a static concentration of 21% oxygen may be inappropriate for preterm infants with lung disease.Purpose of the study is to investigate if preterm neonates where resuscitation is initiated with 21% fiO2 and adjusted to meet transitional goal saturations (Limited oxygen strategy or LOX) would have less oxidative stress as measured by the oxidative balance ratio of biological antioxidant potential/total hydroperoxide compared to infants where resuscitation is initiated with pure oxygen and titrated for targeted saturations of 85-94% (Traditional oxygen strategy or TOX). Secondary outcomes of interest included need for other delivery room resuscitation measures, respiratory support and ventilation/oxygenation status upon neonatal intensive care unit (NICU) admission, survival to hospital discharge, bronchopulmonary dysplasia and other short-term morbidities.


Options:
A: Arm Label: Surfactant and Low Oxygen; Type: EXPERIMENTAL; Interventions: Drug: Surfactant, Drug: Supplemental oxygen with target saturation of 85 to 89% | Arm Label: Surfactant and High Oxygen; Type: EXPERIMENTAL; Interventions: Drug: Surfactant, Drug: Supplemental oxygen with target saturation of 91 to 95% | Arm Label: CPAP and Low Oxygen; Type: EXPERIMENTAL; Interventions: Device: Continuous Positive Airway Pressure (CPAP), Drug: Supplemental oxygen with target saturation of 85 to 89% | Arm Label: CPAP and High Oxygen; Type: EXPERIMENTAL; Interventions: Device: Continuous Positive Airway Pressure (CPAP), Drug: Supplemental oxygen with target saturation of 91 to 95% | Intervention Type: DRUG; Name: Surfactant; Assigned to Arm(s): Surfactant and High Oxygen, Surfactant and Low Oxygen | Intervention Type: DEVICE; Name: Continuous Positive Airway Pressure (CPAP); Assigned to Arm(s): CPAP and High Oxygen, CPAP and Low Oxygen | Intervention Type: DRUG; Name: Supplemental oxygen with target saturation of 85 to 89%; Assigned to Arm(s): CPAP and Low Oxygen, Surfactant and Low Oxygen | Intervention Type: DRUG; Name: Supplemental oxygen with target saturation of 91 to 95%; Assigned to Arm(s): CPAP and High Oxygen, Surfactant and High Oxygen
B: Arm Label: High Oxygen saturation; Type: EXPERIMENTAL; Interventions: Procedure: Higher oxygen saturation target range (91%-95%) | Arm Label: Lower oxygen saturation; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Lower oxygen saturation (85%-89%) | Intervention Type: PROCEDURE; Name: Higher oxygen saturation target range (91%-95%); Assigned to Arm(s): High Oxygen saturation | Intervention Type: PROCEDURE; Name: Lower oxygen saturation (85%-89%); Assigned to Arm(s): Lower oxygen saturation
C: Arm Label: 1; Type: EXPERIMENTAL; Interventions: Other: Titration of oxygen therapy | Arm Label: 2; Type: ACTIVE_COMPARATOR; Interventions: Other: Titration of oxygen therapy | Intervention Type: OTHER; Name: Titration of oxygen therapy; Assigned to Arm(s): 1, 2
D: Arm Label: Low Oxygen Strategy; Type: EXPERIMENTAL; Interventions: Procedure: Titration of oxygen during newborn resuscitation in delivery room | Arm Label: Traditional Oxygen strategy ( TOX); Type: ACTIVE_COMPARATOR; Interventions: Procedure: Titration of oxygen during newborn resuscitation in delivery room | Intervention Type: PROCEDURE; Name: Titration of oxygen during newborn resuscitation in delivery room; Assigned to Arm(s): Low Oxygen Strategy, Traditional Oxygen strategy ( TOX)

Answer: D