Oxygen is essential for life. It also has proven therapeutic value in newborn infants to correct hypoxia and prevent the many complications of hypoxia, decrease the incidence and severity of apnea in premature infants, dilate the pulmonary arteries and increase pulmonary blood flow, and constrict the ductus arteriosus. Although its essential role in life is well known, oxygen also is potentially toxic. Oxygen therapy to reduce apnea in the 1940s led to an increased incidence of retinopathy of prematurity (ROP), known then as retrolental fibroplasia. Breathing higher than normal oxygen concentrations also causes pulmonary epithelial injury and has been implicated as a principal cause of chronic lung disease and bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome. Within and adjacent to cells throughout the body, oxygen can react with prooxidants to produce reactive oxygen species that then produce inflammation and even cell death.

In this month's issue, Dr Phelps...

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