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Comparison of two devices for automated oxygen control in preterm infants: a randomised crossover trial

Citation

Salverda, HH and Cramer, SJE and Witlox, RSGM and Gale, TJ and Dargaville, PA and Pauws, SC and Te Pas, AB, Comparison of two devices for automated oxygen control in preterm infants: a randomised crossover trial, Archives of Disease in Childhood. Fetal and Neonatal Edition Article online ahead of print. ISSN 1359-2998 (2021) [Refereed Article]


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Author(s) (or their employer(s)) 2021. Re-use permitted under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)license, (https://creativecommons.org/licenses/by-nc/4.0/). No commercial re-use. See rights and permissions. Published by BMJ.

DOI: doi:10.1136/archdischild-2020-321387

Abstract

Objective: To compare the effect of two different automated oxygen control devices on target range (TR) time and occurrence of hypoxaemic and hyperoxaemic episodes.

Design: Randomised cross-over study.

Setting: Tertiary level neonatal unit in the Netherlands.

Patients: Preterm infants (n=15) born between 24+0 and 29+6 days of gestation, receiving invasive or non-invasive respiratory support with oxygen saturation (SpO2) TR of 91%-95%. Median gestational age 26 weeks and 4 days (IQR 25 weeks 3 days-27 weeks 6 days) and postnatal age 19 (IQR 17-24) days.

Interventions: Inspired oxygen concentration was titrated by the OxyGenie controller (SLE6000 ventilator) and the CLiO2 controller (AVEA ventilator) for 24 hours each, in a random sequence, with the respiratory support mode kept constant.

Main outcome measures: Time spent within set SpO2 TR (91%-95% with supplemental oxygen and 91%-100% without supplemental oxygen).

Results: Time spent within the SpO2 TR was higher during OxyGenie control (80.2 (72.6-82.4)% vs 68.5 (56.7-79.3)%, p<0.005). Less time was spent above TR while in supplemental oxygen (6.3 (5.1-9.9)% vs 15.9 (11.5-30.7)%, p<0.005) but more time spent below TR during OxyGenie control (14.7 (11.8%-17.2%) vs 9.3 (8.2-12.6)%, p<0.05). There was no significant difference in time with SpO2 <80% (0.5 (0.1-1.0)% vs 0.2 (0.1-0.4)%, p=0.061). Long-lasting SpO2 deviations occurred less frequently during OxyGenie control.

Conclusions: The OxyGenie control algorithm was more effective in keeping the oxygen saturation within TR and preventing hyperoxaemia and equally effective in preventing hypoxaemia (SpO2 <80%), although at the cost of a small increase in mild hypoxaemia.

Item Details

Item Type:Refereed Article
Keywords:neonatology, technology
Research Division:Biomedical and Clinical Sciences
Research Group:Paediatrics
Research Field:Neonatology
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Neonatal and child health
UTAS Author:Gale, TJ (Dr Timothy Gale)
UTAS Author:Dargaville, PA (Professor Peter Dargaville)
ID Code:147012
Year Published:2021
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-10-08
Last Modified:2021-11-19
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