Comparison of two devices for automated oxygen control in preterm infants: a randomised crossover trial. Issue 1 (10th June 2021)

• Record Type: Journal Article
• Authors: Salverda, Hylke H; Cramer, Sophie J E; Witlox, Ruben S G M; Gale, Timothy J; Dargaville, Peter A; Pauws, Steffen C; te Pas, Arjan B
• Is Part Of: Archives of disease in childhood. Volume 107:Issue 1(2022)
• Page Start: 20
• Page End: 25
• Publication Date: 2021-06-10
• Subjects: neonatology -- technology; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2020-321387
• Languages: English
• ISSNs: 1359-2998

Abstract

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. Trial registry number: NCT03877198