Adaptive control of inspired oxygen delivery to the neonate

Adaptive adjustment of inspired oxygen (F io 2), based on a desired percent arterial hemoglobin saturation (S 0 2) was achieved by on‐line bedside control of the oxygen concentration delivered to the neonate. Fourteen infants with bronchopulmonary dysplasia (BW, 860 ± 80 g; GA, 26 ± 1 weeks; study age, 41 ± 8 days) receiving oxygen‐air mixtures by hood were studied. The desired range of S, from 92 to 96% with a target value of 95% was determined by pulse oximetry and maintained with adjustment of F io 2 using three modes: (1) standard neonatal intensive care protocol with oxygen delivery evaluated at 20 minute intervals; (2) bedside manual control with F io 2 manipulation every 2 to 5 minutes; and (3) adaptive control with on‐line adjustment of F io 2 according to a specifically designed adaptive program. Each study period was of 40 minute duration. S o 2, values within a steady 94 to 96% range was achieved for 54010 of the time with standard protocol, compared to 69% ( P < 0.01) with bedside manual control and 81% (P < 0.01) with adaptive control. In addition, fluctuations in S o 2, values and overshoots were less apparent with adaptive control of oxygen delivery. These data describe adaptive F io 2, control as an efficient alternative technique for achieving a stable desired range of oxygenation in neonates. © 1992 Wiley‐Liss, Inc.