PRESOX

The PRESOX trial is a follow-up study based on the respresoxults found in the REOX trial. Apart from the clinical objectives described below, in this international multi-center double-blinded randomized clinical trial for studying the effects of resuscitation of premature infants of extremely low gestational age initiated with different oxygen concentrations further emphasize is put on the identification and evaluation of new biomarkers employing metabolomics. The PRESOX trial also comprises a relatively new approach denominated untarget metabolomics, which involves a systematic study of the unique biochemical fingerprint with the overall objective to discover new biomarkes of hyperoxia in resuscitated preterm neonates employing LC-MS/MS. Furthermore, in a target approach, known biomarkers of free radical damage and lipid peroxidation are evaluated using LC-MS/MS detection. Another additional objective of this trial is the detection of abnormal genomic DNA copies employing Polymerase Chain Reaction (PCR), as the ability to repair DNA strands is vital for cells and thus for the whole organism to assure normal functioning and avoid senescence or apoptosis.

REOX

The REOX trial is a national multi-center double-blinded reoxrandomized clinical trial for studying the effects of resuscitation of premature infants of extremely low gestational age initiated with a low oxygen concentration in comparison to resuscitation initiated with a high oxygen level. The objectives of this clinical trial are to increase survival rate and reduce the occurrence of significant morbidities typically observed in premature infants, such as e.g. severe retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD). Furthermore measures of oxidative stress are expected to decrease when initiating resuscitation with low oxygen levels. Recently, several parameters measured in blood or urine samples have shown their usefulness for assessing oxidative stress. In this clinical trial in the first place the glutathione/glutathione disulfide (GSH/GSSG) ratio is determined, which is considered being a good index of the redox status representing the true effect of fetal to neonatal transition. Additional parameters for assessing protein and DNA oxidation are determined employing reliable and straightforward methods based on liquid chromatography with tandem mass spectrometric (LC-MS/MS) detection, that have been developed in our group.