Automatic oxygen control for reducing extremes of oxygen saturation: a randomised controlled trial. Issue 2 (23rd August 2022)

• Record Type: Journal Article
• Authors: Nair, Vrinda; Kannan Loganathan, Prakash; Lal, Mithilesh Kumar; Pringleton, Helen; Bachman, Thomas Edward; Brodlie, Malcolm; Dixon, Paul
• Is Part Of: Archives of disease in childhood. Volume 108:Issue 2(2023)
• Page Start: 136
• Page End: 141
• Publication Date: 2022-08-23
• Subjects: Neonatology -- Intensive Care Units, Neonatal; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2022-324160
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Objective: The objective of this study was to evaluate the efficacy of the automatic oxygen control (A-Fio2 ) in reducing the percentage of time spent in severe hypoxaemia (Spo2 <80%) in preterm infants for the time period on invasive ventilation and/or nasal continuous positive airway pressure (NCPAP) delivered by AVEA ventilator. Design: A parallel arm randomised controlled trial. Setting: A level-III neonatal intensive care unit. Patients: Preterm infants (<33 weeks birth gestation) who received invasive ventilation or NCPAP in the first 72 hours of age. Interventions: A-Fio2 vs manual (M-Fio2 ) oxygen control. Outcomes: The primary outcome of the study was percentage of time spent in severe hypoxaemia (Spo2 <80%). Results: 44 infants were randomised to either A-Fio2 or M-Fio2 arm and continued in the study for the period of respiratory support (invasive ventilation and/or NCPAP). The total number of study days in A-Fio2 and M-Fio2 arm were 194 and 204 days, respectively. The percentage of time spent in Spo2 <80% was significantly lower with A-Fio2 compared with M-Fio2 (median of 0.1% (IQR: 0.07–0.7) vs 0.6% (0.2–2); p=0.03). The number of prolonged episodes (>60 s) of Spo2 <80% per day was also significantly lower in A-Fio2 (0.3 (0.0–2) vs 2 (0.6–6); p=0.02). Conclusion: A-Fio2 was associated with statistically significant reduction in the percentage of time spent in severe hypoxaemia when compared with M-Fio2 in preterm infants receiving respiratory support. Trial registration number: NCT04223258 . Abstract : In this randomised controlled trial that included 44 infants, servo controlled adjustment of FiO2 improved oxygen targeting over the duration of ventilation and nasal CPAP treatment.