Automated versus Manual Oxygen Control with Different Saturation Targets and Modes of Respiratory Support in Preterm Infants
Language English Country United States Media print-electronic
Document type Journal Article, Multicenter Study, Randomized Controlled Trial
PubMed
26144575
DOI
10.1016/j.jpeds.2015.06.012
PII: S0022-3476(15)00595-8
Knihovny.cz E-resources
- MeSH
- Intensive Care Units, Neonatal MeSH
- Cross-Over Studies MeSH
- Oxygen blood therapeutic use MeSH
- Humans MeSH
- Infant, Premature MeSH
- Infant, Newborn MeSH
- Oximetry methods MeSH
- Respiration, Artificial methods MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Infant, Newborn MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
- Geographicals
- Europe MeSH
- Canada MeSH
- Names of Substances
- Oxygen MeSH
OBJECTIVE: To determine the efficacy and safety of automated adjustment of the fraction of inspired oxygen (FiO2) in maintaining arterial oxygen saturation (SpO2) within a higher (91%-95%) and a lower (89%-93%) target range in preterm infants. STUDY DESIGN: Eighty preterm infants (gestational age [median]: 26 weeks, age [median] 18 days) on noninvasive (n = 50) and invasive (n = 30) respiratory support with supplemental oxygen, were first randomized to one of the SpO2 target ranges and then treated with automated FiO2 (A-FiO2) and manual FiO2 (M-FiO2) oxygen control for 24 hours each, in random sequence. RESULTS: The percent time within the target range was higher during A-FiO2 compared with M-FiO2 control. This effect was more pronounced in the lower SpO2 target range (62 ± 17% vs 54 ± 16%, P < .001) than in the higher SpO2 target range (62 ± 17% vs 58 ± 15%, P < .001). The percent time spent below the target or in hypoxemia (SpO2 <80%) was consistently reduced during A-FiO2, independent of the target range. The time spent above the target range or at extreme hyperoxemia (SpO2 >98%) was only reduced during A-FiO2 when targeting the lower SpO2 range (89%-93%). These outcomes did not differ between infants on noninvasive and invasive respiratory support. Manual adjustments were significantly reduced during A-FiO2 control. CONCLUSIONS: A-FiO2 control improved SpO2 targeting across different SpO2 ranges and reduced hypoxemia in preterm infants on noninvasive and invasive respiratory support. TRIAL REGISTRATION: ISRCTN 56626482.
Alberta Children's Hospital Calgary Canada
Czech Technical University Prague Prague Czech Republic; Economedtrx Lake Arrowhead CA
Emma Children's Hospital AMC Amsterdam The Netherlands
James Cook University Hospital Middlesbrough United Kingdom
Leiden University Medical Center Leiden The Netherlands
Silesian Institute Mother and Newborn Chorzow Poland
The Medical Center of Postgraduate Education Warsaw Poland
University Hospital North Tees Stockton Cleveland United Kingdom
References provided by Crossref.org
ISRCTN
ISRCTN56626482
