Is room air better than 100% oxygen for the resuscitation of the depressed full-term newborn?

Recently, I was called for resuscitation of a newborn infant with bradycardia and no respiratory effort at birth. The hospital has a practice (currently under review) of using 100% oxygen for newborn resuscitation. As a paediatric trainee, having trained in various regions of the UK, I have noticed that units vary in their choice between use of room air and the more conventional 100% oxygen for neonatal resuscitation. What is the evidence behind using room air versus 100% oxygen in resuscitation of the depressed newborn?

Structured clinical question

During resuscitation of the depressed newborn [patient], does the use of room air [intervention] when compared with 100% oxygen [comparison], reduce the risk of (a) neonatal mortality and (b) adverse neuro-development [outcome]?

Search strategy and outcome

Secondary sources

The Cochrane library was searched. The search term was: [Newborn resuscitation AND Oxygen OR air]. Search results were: 24 hits, of which three …