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Automated control of inspired oxygen in ventilated preterm infants: crossover physiological study
Author(s) -
Lal Mithilesh,
Tin Win,
Sinha Sunil
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13137
Subject(s) - medicine , target range , fraction of inspired oxygen , crossover study , oxygen saturation , pulse oximetry , hypoxemia , oxygen , anesthesia , supplemental oxygen , mechanical ventilation , chemistry , alternative medicine , organic chemistry , pathology , economics , macroeconomics , placebo
Aim To evaluate the efficacy of automated control of the fraction of inspired oxygen (FiO 2 ) in comparison with manual FiO 2 control in maintaining target pulse oxygen saturation (SpO 2 ) range. Methods Crossover physiological study involving preterm infants requiring mechanical ventilation and supplemental oxygen. Each infant was studied for two consecutive 12 hours in a random sequence. Outcome measures included the proportion of time with SpO 2 within and outside the target range of 90–95%, extreme hypoxaemia (<80%) and hyperoxaemia (≥98%). Results Complete data set was available in 27 infants. The percentage of time (median, IQR ) within the target range was higher during automated control 72.8 (58.8–82.6) compared to manual control 59.6 (49.3–73.3), p = 0.031. Corresponding reduction in per cent time below the target range was 18.1 (12.7–23.6) versus 25.9 (17.8–30.7), p = 0.028, and above the target range 4.8 (3–16) versus 10.1 (6.4‐22.5), p = 0.026. Median ( IQR ) per cent time spent with severe hypoxaemia (SpO 2 <80%) and severe hyperoxaemia (SpO 2 ≥98%) was 1.3 (0.1–2.9) versus 3.2 (1.4–6.1), p = 0.022 and 0.08 (0.05–0.36) versus 1.7 (0.7–6.8), p = 0.001, respectively. Median number of manual adjustments of FiO 2 per 12 hour was 0 and 63, respectively. Conclusion Automated control of FiO 2 significantly improved compliance of oxygen saturation targeting and significantly reduced exposure to hypoxaemia as well as hyperoxaemia.