# Optimal Oxygenation in Neonatal Lung Injury

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA AT DAVIS · 2020 · $327,738

## Abstract

SUMMARY
Title: Optimal Oxygenation in Neonatal Lung Injury
The current guidelines for neonatal resuscitation recommend the use of 21% oxygen during
initial resuscitation of term newborn infants and use of blended supplemental oxygen to
maintain target saturations to provide adequate oxygen while limiting damage from reactive
oxygen radicals. The American Academy of Pediatrics recommends maintaining PaO2 between
50 and 80 mmHg in the management of sick neonates. These recommendations are based on
studies using oxygen saturations in human infants and through translational studies in neonatal
animal models without lung disease. Optimal oxygen concentration and target oxygen saturation
range during resuscitation and ventilation of term neonates with lung injury/disease has been
tested by this lab in term newborn lambs. SPO2 is not the sole determinant of oxygenation.
When considering treatment that focuses on protecting brain function following birth with
meconium aspiration/asphyxia, the same treatment may compromise pulmonary function.
Transition to air breathing is a complex physiologic event, more so when there is significant lung
disease. To further minimize the impact of oxygen damage we propose to study term lambs with
lung injury induced by aspiration of meconium during gasping respirations as a consequence of
umbilical cord occlusion and asphyxia (“asphyxia-MAS”). Limiting optimal target oxygen levels
to two groups, 90-94% and 95-99% (that were found to be best treatment conditions during past
studies) we propose to study 3 additional specific aims to improve both brain and lung function.
The first specific aim will evaluate the hemoglobin level that optimizes cerebral O2 delivery and
extraction, achieved by improving placental transfusion at birth using cord milking procedures
that increase circulating fetal RBC’s. The second aim will randomize the target PaCO2 and pH to
provide the best cerebral blood flow while maintaining low pulmonary vascular resistance,
continually managed by monitoring end-tidal CO2. The last specific aim will study the influence
of hypothermia treatment currently used clinically following asphyxial birth to preserve brain
function. Many factors can influence newborn clinical management of lung disease. We intend
to clarify management criteria to better control the factors that influence hemodynamic
measures of blood flow, pulmonary artery pressure and gas exchange to optimize oxygen
delivery and extraction for both brain and lung function while limiting damage from oxygen free
radicals.

## Key facts

- **NIH application ID:** 9993982
- **Project number:** 5R01HD072929-10
- **Recipient organization:** UNIVERSITY OF CALIFORNIA AT DAVIS
- **Principal Investigator:** Satyanarayana Lakshminrusimha
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $327,738
- **Award type:** 5
- **Project period:** 2012-08-06 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9993982

## Citation

> US National Institutes of Health, RePORTER application 9993982, Optimal Oxygenation in Neonatal Lung Injury (5R01HD072929-10). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9993982. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*