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Assessment of portable oxygen concentrators in infants undergoing hypoxic challenge testing. A randomised controlled crossover trial
Author(s) -
Sailer Sebastian,
Osona Rodriguez de Torres Borja,
Gil Sanchez José Antonio,
Bover Bauzà Catalina,
VetterLaracy Susanne,
Figuerola Mulet Joan
Publication year - 2020
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.15242
Subject(s) - medicine , hypoxia (environmental) , crossover study , anesthesia , adverse effect , randomized controlled trial , gestational age , supplemental oxygen , effects of high altitude on humans , pediatrics , oxygen , surgery , pregnancy , placebo , chemistry , alternative medicine , organic chemistry , pathology , anatomy , biology , genetics
Aim Due to reduced PaO 2 , aircrafts at cruising altitudes are pressurised to a cabin altitude of 2438 m, equivalent to breathing FiO 2 0.15. Portable oxygen concentrators (POCs) are approved for onboard oxygen supply with lack of evidence, especially in infants. We assessed POCs (continuous‐flow cPOC vs. pulsed‐flow pPOC) under simulated altitude conditions performing Hypoxic Challenge Testing (HCT). Methods In a randomised controlled crossover trial, we included patients <1 year born prematurely. In incidents of hypoxia (SpO 2 ≤ 85%), oxygen was administered through POC. In patients with a positive hypoxia reversal, HCT was repeated 24 hours later. If hypoxia occurred during the second testing, oxygen was given using the alternative POC. Results We randomised 26 patients; 22 patients received allocated intervention (4 dropped out). Mean gestational age 30.4 weeks, mean corrected age 38.2 weeks. Both POCs achieved immediate hypoxia reversal in all cases (SpO 2 cPOC/pPOC 98%/99.4% (95%CI −2.91, 0.01)) without any adverse events. No significant difference was observed in patients with BPD. Conclusion Both POCs generated sufficient oxygen to reverse HCT induced hypoxia. Although pPOCs are not recommended in paediatric age, our data suggest their effectiveness even in neonates without any associated adverse events. Future research on pPOCs safety is required to establish recommendations for their use.