Automated Adjustment of Inspired Oxygen in Preterm Infants with Frequent Fluctuations in Oxygenation

A Pilot Clinical Trial

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70 Citations (Scopus)

Abstract

Objective: To assess the efficacy of a system for automated fraction of inspired oxygen (FiO2) adjustment in maintaining oxygen saturation (SpO2) within an intended range in preterm infants with spontaneous fluctuations in SpO2. Study design: Sixteen infants (gestational age, 24.9 ± 1.4 weeks; birth weight, 678 ± 144 g; age, 33 ± 15 days) with frequent hypoxemia episodes underwent two 4-hour periods of FiO2 adjustment by clinical personnel (routine) and the automated system (automated). Results: Compared with the routine period, the percent time within intended SpO2 range (88%-95%) increased during the automated period (58% ± 10% versus 42% ± 9%; P < .001), whereas the percent time with SpO2 higher than the intended range and ≥98% were reduced (9% ± 10% versus 31% ± 8% [P < .001] and 3% ± 5% versus 16% ± 9% [P < .001], respectively). Percent time with SpO2 < 88% increased during the automated period (33% ± 7% versus 27% ± 9%; P = .003) because of more frequent episodes, whereas the time with SpO2 < 75% did not differ. The 4-hour median FiO2 was lower during the automated period (29% ± 4% versus 34% ± 5%; P < .001). Conclusion: Automated FiO2 adjustment improved maintenance of SpO2 within the intended range and reduced hyperoxemia and FiO2. These findings should be examined in longer periods with standard clinical conditions and, eventually, in the context of randomized trials powered to detect clinically important effects on outcome.

Original languageEnglish
JournalJournal of Pediatrics
Volume155
Issue number5
DOIs
StatePublished - Nov 1 2009

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Premature Infants
Clinical Trials
Oxygen
Birth Weight
Gestational Age
Maintenance

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

@article{b9f4e2b4f9c748f586572e2deb1c88d0,
title = "Automated Adjustment of Inspired Oxygen in Preterm Infants with Frequent Fluctuations in Oxygenation: A Pilot Clinical Trial",
abstract = "Objective: To assess the efficacy of a system for automated fraction of inspired oxygen (FiO2) adjustment in maintaining oxygen saturation (SpO2) within an intended range in preterm infants with spontaneous fluctuations in SpO2. Study design: Sixteen infants (gestational age, 24.9 ± 1.4 weeks; birth weight, 678 ± 144 g; age, 33 ± 15 days) with frequent hypoxemia episodes underwent two 4-hour periods of FiO2 adjustment by clinical personnel (routine) and the automated system (automated). Results: Compared with the routine period, the percent time within intended SpO2 range (88{\%}-95{\%}) increased during the automated period (58{\%} ± 10{\%} versus 42{\%} ± 9{\%}; P < .001), whereas the percent time with SpO2 higher than the intended range and ≥98{\%} were reduced (9{\%} ± 10{\%} versus 31{\%} ± 8{\%} [P < .001] and 3{\%} ± 5{\%} versus 16{\%} ± 9{\%} [P < .001], respectively). Percent time with SpO2 < 88{\%} increased during the automated period (33{\%} ± 7{\%} versus 27{\%} ± 9{\%}; P = .003) because of more frequent episodes, whereas the time with SpO2 < 75{\%} did not differ. The 4-hour median FiO2 was lower during the automated period (29{\%} ± 4{\%} versus 34{\%} ± 5{\%}; P < .001). Conclusion: Automated FiO2 adjustment improved maintenance of SpO2 within the intended range and reduced hyperoxemia and FiO2. These findings should be examined in longer periods with standard clinical conditions and, eventually, in the context of randomized trials powered to detect clinically important effects on outcome.",
author = "Claure, {Nelson R} and Carmen D'Ugard and Eduardo Bancalari",
year = "2009",
month = "11",
day = "1",
doi = "10.1016/j.jpeds.2009.04.057",
language = "English",
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T1 - Automated Adjustment of Inspired Oxygen in Preterm Infants with Frequent Fluctuations in Oxygenation

T2 - A Pilot Clinical Trial

AU - Claure, Nelson R

AU - D'Ugard, Carmen

AU - Bancalari, Eduardo

PY - 2009/11/1

Y1 - 2009/11/1

N2 - Objective: To assess the efficacy of a system for automated fraction of inspired oxygen (FiO2) adjustment in maintaining oxygen saturation (SpO2) within an intended range in preterm infants with spontaneous fluctuations in SpO2. Study design: Sixteen infants (gestational age, 24.9 ± 1.4 weeks; birth weight, 678 ± 144 g; age, 33 ± 15 days) with frequent hypoxemia episodes underwent two 4-hour periods of FiO2 adjustment by clinical personnel (routine) and the automated system (automated). Results: Compared with the routine period, the percent time within intended SpO2 range (88%-95%) increased during the automated period (58% ± 10% versus 42% ± 9%; P < .001), whereas the percent time with SpO2 higher than the intended range and ≥98% were reduced (9% ± 10% versus 31% ± 8% [P < .001] and 3% ± 5% versus 16% ± 9% [P < .001], respectively). Percent time with SpO2 < 88% increased during the automated period (33% ± 7% versus 27% ± 9%; P = .003) because of more frequent episodes, whereas the time with SpO2 < 75% did not differ. The 4-hour median FiO2 was lower during the automated period (29% ± 4% versus 34% ± 5%; P < .001). Conclusion: Automated FiO2 adjustment improved maintenance of SpO2 within the intended range and reduced hyperoxemia and FiO2. These findings should be examined in longer periods with standard clinical conditions and, eventually, in the context of randomized trials powered to detect clinically important effects on outcome.

AB - Objective: To assess the efficacy of a system for automated fraction of inspired oxygen (FiO2) adjustment in maintaining oxygen saturation (SpO2) within an intended range in preterm infants with spontaneous fluctuations in SpO2. Study design: Sixteen infants (gestational age, 24.9 ± 1.4 weeks; birth weight, 678 ± 144 g; age, 33 ± 15 days) with frequent hypoxemia episodes underwent two 4-hour periods of FiO2 adjustment by clinical personnel (routine) and the automated system (automated). Results: Compared with the routine period, the percent time within intended SpO2 range (88%-95%) increased during the automated period (58% ± 10% versus 42% ± 9%; P < .001), whereas the percent time with SpO2 higher than the intended range and ≥98% were reduced (9% ± 10% versus 31% ± 8% [P < .001] and 3% ± 5% versus 16% ± 9% [P < .001], respectively). Percent time with SpO2 < 88% increased during the automated period (33% ± 7% versus 27% ± 9%; P = .003) because of more frequent episodes, whereas the time with SpO2 < 75% did not differ. The 4-hour median FiO2 was lower during the automated period (29% ± 4% versus 34% ± 5%; P < .001). Conclusion: Automated FiO2 adjustment improved maintenance of SpO2 within the intended range and reduced hyperoxemia and FiO2. These findings should be examined in longer periods with standard clinical conditions and, eventually, in the context of randomized trials powered to detect clinically important effects on outcome.

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