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What FiO2 should you start at for a 34-week preterm infant who needs help breathing at birth? On this Journal Club, Ben reviews the AIROPLANE trial, a cluster randomized crossover study across 26 Australian maternity hospitals comparing initial FiO2 of 30% versus 21% in 1,818 infants born at 32 to 35 weeks. Ongoing respiratory support leaving the delivery room was nearly identical between groups, but infants started at 30% needed less escalation in the delivery room and less endotracheal ventilation afterward. Ben places the findings alongside ILCOR guidance and the TORPIDO 30/60 trial, and explains why this common population has gone understudied for so long. Daphna and Ben agree: for now, consistency is the best practice.
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Oxygen vs Air at Birth for Moderate- to Late-Preterm Infants: The AIROPLANE Cluster Randomized Crossover Trial. Peart SR, Manley BJ, Cheong JLY, Oei JL, Grobler AC, Moore CL, Allen RL, Alda MG, Bell G, Bhola K, Carman K, de Waal K, Dombagahawaththage CAN, Fan WQ, Fang AYW, Goyadi PK, Houghton KA, Jain KF, John J, Joshi D, Kunjunju A, Marshall IR, Mills JF, Nichol J, Parkhurst K, Priyadarshi A, Roberts CT, Thomas N, Tickell DJ, Walsh T, Yates KM, Ziffer J, Davis PG, Owen LS; AIROPLANE Trial Investigators and the IMPACT Clinical Trials Network for Mothers’ and Babies’ Health.JAMA. 2026 Sep 9:e2614201. doi: 10.1001/jama.2026.14201. Online ahead of print.PMID: 42714881
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