A newborn term infant is receiving oxygen by oxyhood and has a SpO2 of 72%. What is the appropriate action for the neonatal/pediatric specialist?

In this scenario, the newborn term infant is receiving oxygen via oxyhood and has a significantly low oxygen saturation (SpO2) of 72%. Such a low level of SpO2 indicates severe hypoxemia, which requires immediate intervention to ensure adequate oxygenation and prevent potential damage to vital organs.

Initiating mechanical ventilation is appropriate in this context because it provides a controlled and higher level of oxygen directly into the lungs, optimizing gas exchange and improving oxygenation rapidly. Mechanical ventilation allows for precise control over the delivered tidal volume and oxygen concentration (FiO2), which is critical in critically ill neonates who cannot maintain adequate oxygen levels on their own.

Other options, while they may have roles in managing respiratory issues, do not address the urgent need for life-sustaining intervention indicated by the severely low SpO2. Increasing the FiO2 might provide some benefit; however, it may not be sufficient for a newborn in such critical condition and does not address the possibility that the infant may require additional respiratory support through mechanical ventilation.

Therefore, initiating mechanical ventilation is the appropriate escalation step in response to this alarming level of hypoxemia.