TY - JOUR T1 - 2022 Eastern Regional Meeting JF - Journal of Investigative Medicine JO - J Investig Med SP - 977 LP - 1202 DO - 10.1136/jim-2022-ERM VL - 70 IS - 4 A2 - , Y1 - 2022/04/01 UR - http://hw-f5-jim.highwire.org/content/70/4/977.abstract N2 - #1 The hemodynamic benefits of brief 100% oxygen use during preterm resuscitation with an intact umbilical cord using asphyxiated and non-asphyxiated surfactant deficient ovine modelP Chandrasekharan1*S Gugino1 J Helman1 N Bradley1 L Nielsen1 M Bawa1 A Mari1 A Prasath1 C Blanco1 M Rawat1 S Lakshminrusimha2 1State University of New York at Buffalo, Buffalo, NY 2UC Davis, Davis, CA Purpose of Study The use of 100% supplemental O2 is not recommended in the resuscitation of preterm neonates due to the risk of systemic oxygen toxicity. A recent meta-analysis suggests that more than 50% of preterm infants are born with a heart rate < 100 bpm. Not achieving an HR of ≥100bpm and saturation (SpO2) of ≥80% by 5 min places a preterm infant at a higher risk of morbidity/mortality. Ventilation with an intact cord improves hemodynamic transition in a preterm neonate. In an asphyxiated preterm neonate, the use of 100% O2 with an intact cord could improve alveolar oxygenation with less systemic toxicity due to buffering by umbilical venous return. Our objectives are to study the effect of initiating positive pressure ventilation (PPV) with 100% O2 with and without an intact umbilical cord in asphyxiated and non-asphyxiated preterm lambs. Methods Used Preterm lambs (125-127d gestation) were randomized to 4 groups a) AXDCC – asphyxiated (to HR < 100 bpm) and ventilated with an intact cord, b) AXECC – asphyxiated, early cord clamping and PPV, c) NoAXDCC – non-asphyxiated delayed cord clamping, d) NoAXECC – non-asphyxiated, early cord clamping. The cord clamping is delayed in all DCC groups for 5 min. The primary outcome is the incidence of HR of ≥ 100 bpm and SpO2 of ≥80% by 5 min. The secondary outcomes were measures of gas exchange, hemodynamics, and oxidative stress (oxidized to reduced glutathione ratio in the blood). In all the groups PPV was … ER -