I read with interest the article by Vento et al that examined the important question of delivery room resuscitation of newborns with room air instead of 100% oxygen. The finding of protracted oxidative stress at 28 days in the 100% resuscitated group is both intriguing and provocative, however difficult to reconcile because of significant limitations in the methodology and data presented. Specifically, in the “Methods” section it is stated that “eligible infants showed clinical and biochemical evidence of asphyxia.” Because it is also stated that the umbilical arterial blood was obtained before the onset of resuscitation (see “Results,” page 644), it is unclear how this was accomplished and what resuscitation measures were taken while awaiting the results. This also raises the important question of how many randomized infants were subsequently excluded because they did not have biochemical evidence of asphyxia or because they were severely asphyxiated. Moreover, the arterial...

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