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Automation of oxygen titration in preterm infants: current evidence and future challenges


Dargaville, PA and Marshall, AP and McLeod, L and Salverda, HH and te Pas, AB and Gale, TJ, Automation of oxygen titration in preterm infants: current evidence and future challenges, Early Human Development, 162 Article 105462. ISSN 0378-3782 (2021) [Refereed Article]

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2021 Elsevier B.V. All rights reserved.

DOI: doi:10.1016/j.earlhumdev.2021.105462


For the preterm infant with respiratory insufficiency requiring supplemental oxygen, tight control of oxygen saturation (SpO2) is advocated, but difficult to achieve in practice. Automated control of oxygen delivery has emerged as a potential solution, with six control algorithms currently embedded in commercially-available respiratory support devices. To date, most clinical evaluations of these algorithms have been short-lived crossover studies, in which a benefit of automated over manual control of oxygen titration has been uniformly noted, along with a reduction in severe SpO2 deviations and need for manual FiO2 adjustments. A single non-randomised study has examined the effect of implementation of automated oxygen control with the CLiO2 algorithm as standard care for preterm infants; no clear benefits in relation to clinical outcomes were noted, although duration of mechanical ventilation was lessened. The results of randomised controlled trials are awaited. Beyond the gathering of evidence regarding a treatment effect, we contend that there is a need for a better understanding of the function of contemporary control algorithms under a range of clinical conditions, further exploration of techniques of adaptation to individualise algorithm performance, and a concerted effort to apply this technology in low resource settings in which the majority of preterm infants receive care. Attainment of these goals will be paramount in optimisation of oxygen therapy for preterm infants globally.

Item Details

Item Type:Refereed Article
Keywords:infant preterm, oxygen therapy, oxygen saturation targeting, automation, control
Research Division:Engineering
Research Group:Biomedical engineering
Research Field:Medical devices
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Dargaville, PA (Professor Peter Dargaville)
UTAS Author:Marshall, AP (Mr Andrew Marshall)
UTAS Author:McLeod, L (Mr Lachlann McLeod)
UTAS Author:Gale, TJ (Dr Timothy Gale)
ID Code:149236
Year Published:2021
Web of Science® Times Cited:5
Deposited By:Engineering
Deposited On:2022-03-18
Last Modified:2022-08-25
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