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Aim  Providing consistent levels of oxygen saturation (SpO 2 ) for infants in neonatal intensive care units is not easy. This study explored how effectively the Auto‐Mixer ®  algorithm automatically adjusted fraction of inspired oxygen (FiO 2 ) levels to maintain SpO 2  within an intended range in extremely low birth weight infants receiving supplemental oxygen without mechanical ventilation.    Methods  Twenty extremely low birth weight infants were randomly assigned to the Auto‐Mixer ®  group or the manual intervention group and studied for 12 h. The SpO 2  target was 85–93%, and the outcomes were the percentage of time SpO 2  was within target, SpO 2  variability, SpO 2  >95%, oxygen received and manual interventions.    Results  The percentage of time within intended SpO 2  was 58 ± 4% in the Auto‐Mixer ®  group and 33.7 ± 4.7% in the manual group, SpO 2  >95% was 26.5% vs 54.8%, average SpO 2  and FiO 2  were 89.8% vs 92.2% and 37% vs 44.1%, and manual interventions were 0 vs 80 (p < 0.05). Brief periods of SpO 2  < 85% occurred more frequently in the Auto‐Mixer ®  group.    Conclusion  The Auto‐Mixer ®  effectively increased the percentage of time that SpO 2  was within the intended target range and decreased the time with high SpO 2  in spontaneously breathing extremely low birth weight infants receiving supplemental oxygen.

acta paediatrica

A randomised controlled trial of an automated oxygen delivery algorithm for preterm neonates receiving supplemental oxygen without mechanical ventilation