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Background:  International consensus statements for resuscitation of newborn infants recommend provision of 100% oxygen once chest compressions are required. However, 100% oxygen exacerbates reperfusion injury and reduces cerebral perfusion in newborn babies.   Objective:  We aimed to establish whether resuscitation with air during chest compression is feasible and safe in newborn infants compared with 100% oxygen.   Methods:  Systematic search of PubMed, Google Scholar and CINAHL for articles examining variable oxygen concentrations during chest compressions in term newborns.   Results:  Overall, no human studies but eight animal studies ( n  = 323 animals) comparing various oxygen concentrations during chest compression were identified. The pooled analysis showed no difference in mortality rates for animals resuscitated with air vs. 100% oxygen (risk ratio 1.04 [0.35, 3.08], I 2  = 0%,  p  = 0.94). ROSC was also similar between groups with a mean difference of −3.8 [−29.7–22] s, I 2  = 0%,  p  = 0.77. No difference in oxygen damage or adverse events were identified between groups.   Conclusions:  Air had similar time to ROSC and mortality as 100% oxygen during neonatal chest compression. A large randomized controlled clinical trial comparing air vs. 100% oxygen during neonatal chest compression is warranted.

A Review of Oxygen Use During Chest Compressions in Newborns—A Meta-Analysis of Animal Data