Hylke Salverda

8 Oxygen is crucial for the survival of all organisms. Without it, there would be no life. This much humankind has known since the first scientists discovered oxygen, one may have been as early as 1604. However, it was not until 1790 that oxygen was first mentioned for medical purposes and it would take another 110 years before it was first used in neonatal care. To get oxygen in our blood to enable the essential metabolic processes in our body, we use our lungs. The lungs of a preterm infant are not fully developed and they are thus not always capable of taking in enough oxygen. This prompts clinicians to give extra oxygen – a key treatment which has helped save many lives. Exactly how much oxygen clinicians can safely give is still unknown and can change within seconds for preterm infants. As with so many things in life, too little or too much can be harmful. A fine balance needs to be kept. In the first half of the 20th century, neonatal care saw little involvement from physicians. Few medical procedures were done to neonates. It was believed that handling during care led to cyanosis and apnoea and as a result, care was mostly limited to warming, feeding and isolation. Giving extra oxygen to preterm infants was also rare. The first mention of administering oxygen to preterm infants was by Budin in 1900, when he reported a beneficial effect of administering oxygen during cyanotic bouts. In the following years physicians noted that administering oxygen could also reduce irregular, also known as periodic, breathing. As a result, extended periods of oxygen administration were recommended and oxygen use for preterm infants became common practice. Oxygen hoods, funnels and even incubators were designed to administer oxygen, all with the aim of mixing in as little ambient air as possible. Preface