Automated versus Manual Oxygen Control with Different Saturation Targets and Modes of Respiratory Support in Preterm Infants

Anton H. van Kaam; Helmut D. Hummler; Maria Wilinska; Janusz Swietlinski; Mithilesh K. Lal; Arjan B. te Pas; Gianluca Lista; Samir Gupta; Carlos A. Fajardo; Wes Onland; Markus Waitz; Malgorzata Warakomska; Francesco Cavigioli; Eduardo Bancalari; Nelson Claure; Thomas E. Bachman

doi:https://doi.org/10.1016/j.jpeds.2015.06.012

Automated versus Manual Oxygen Control with Different Saturation Targets and Modes of Respiratory Support in Preterm Infants

Anton H. van Kaam, Helmut D. Hummler, Maria Wilinska, Janusz Swietlinski, Mithilesh K. Lal, Arjan B. te Pas, Gianluca Lista, Samir Gupta, Carlos A. Fajardo, Wes Onland, Markus Waitz, Malgorzata Warakomska, Francesco Cavigioli, Eduardo Bancalari, Nelson Claure, Thomas E. Bachman

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Abstract

To determine the efficacy and safety of automated adjustment of the fraction of inspired oxygen (FiO2) in maintaining arterial oxygen saturation (SpO2) within a higher (91%-95%) and a lower (89%-93%) target range in preterm infants. Eighty preterm infants (gestational age [median]: 26 weeks, age [median] 18 days) on noninvasive (n = 50) and invasive (n = 30) respiratory support with supplemental oxygen, were first randomized to one of the SpO2 target ranges and then treated with automated FiO2 (A-FiO2) and manual FiO2 (M-FiO2) oxygen control for 24 hours each, in random sequence. The percent time within the target range was higher during A-FiO2 compared with M-FiO2 control. This effect was more pronounced in the lower SpO2 target range (62 ± 17% vs 54 ± 16%, P < .001) than in the higher SpO2 target range (62 ± 17% vs 58 ± 15%, P < .001). The percent time spent below the target or in hypoxemia (SpO2 <80%) was consistently reduced during A-FiO2, independent of the target range. The time spent above the target range or at extreme hyperoxemia (SpO2 >98%) was only reduced during A-FiO2 when targeting the lower SpO2 range (89%-93%). These outcomes did not differ between infants on noninvasive and invasive respiratory support. Manual adjustments were significantly reduced during A-FiO2 control. A-FiO2 control improved SpO2 targeting across different SpO2 ranges and reduced hypoxemia in preterm infants on noninvasive and invasive respiratory support. ISRCTN 56626482

Original language	English
Pages (from-to)	545-50.e1-2
Journal	Journal of pediatrics
Volume	167
Issue number	3
DOIs	https://doi.org/10.1016/j.jpeds.2015.06.012
Publication status	Published - 2015

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https://doi.org/10.1016/j.jpeds.2015.06.012

Cite this

van Kaam, A. H., Hummler, H. D., Wilinska, M., Swietlinski, J., Lal, M. K., te Pas, A. B., Lista, G., Gupta, S., Fajardo, C. A., Onland, W., Waitz, M., Warakomska, M., Cavigioli, F., Bancalari, E., Claure, N., & Bachman, T. E. (2015). Automated versus Manual Oxygen Control with Different Saturation Targets and Modes of Respiratory Support in Preterm Infants. Journal of pediatrics, 167(3), 545-50.e1-2. https://doi.org/10.1016/j.jpeds.2015.06.012

@article{ee3903a5d6464cde99532fb142990627,

title = "Automated versus Manual Oxygen Control with Different Saturation Targets and Modes of Respiratory Support in Preterm Infants",

abstract = "To determine the efficacy and safety of automated adjustment of the fraction of inspired oxygen (FiO2) in maintaining arterial oxygen saturation (SpO2) within a higher (91%-95%) and a lower (89%-93%) target range in preterm infants. Eighty preterm infants (gestational age [median]: 26 weeks, age [median] 18 days) on noninvasive (n = 50) and invasive (n = 30) respiratory support with supplemental oxygen, were first randomized to one of the SpO2 target ranges and then treated with automated FiO2 (A-FiO2) and manual FiO2 (M-FiO2) oxygen control for 24 hours each, in random sequence. The percent time within the target range was higher during A-FiO2 compared with M-FiO2 control. This effect was more pronounced in the lower SpO2 target range (62 ± 17% vs 54 ± 16%, P < .001) than in the higher SpO2 target range (62 ± 17% vs 58 ± 15%, P < .001). The percent time spent below the target or in hypoxemia (SpO2 <80%) was consistently reduced during A-FiO2, independent of the target range. The time spent above the target range or at extreme hyperoxemia (SpO2 >98%) was only reduced during A-FiO2 when targeting the lower SpO2 range (89%-93%). These outcomes did not differ between infants on noninvasive and invasive respiratory support. Manual adjustments were significantly reduced during A-FiO2 control. A-FiO2 control improved SpO2 targeting across different SpO2 ranges and reduced hypoxemia in preterm infants on noninvasive and invasive respiratory support. ISRCTN 56626482",

author = "{van Kaam}, {Anton H.} and Hummler, {Helmut D.} and Maria Wilinska and Janusz Swietlinski and Lal, {Mithilesh K.} and {te Pas}, {Arjan B.} and Gianluca Lista and Samir Gupta and Fajardo, {Carlos A.} and Wes Onland and Markus Waitz and Malgorzata Warakomska and Francesco Cavigioli and Eduardo Bancalari and Nelson Claure and Bachman, {Thomas E.}",

year = "2015",

doi = "https://doi.org/10.1016/j.jpeds.2015.06.012",

language = "English",

volume = "167",

pages = "545--50.e1--2",

journal = "Journal of pediatrics",

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van Kaam, AH, Hummler, HD, Wilinska, M, Swietlinski, J, Lal, MK, te Pas, AB, Lista, G, Gupta, S, Fajardo, CA, Onland, W, Waitz, M, Warakomska, M, Cavigioli, F, Bancalari, E, Claure, N & Bachman, TE 2015, 'Automated versus Manual Oxygen Control with Different Saturation Targets and Modes of Respiratory Support in Preterm Infants', Journal of pediatrics, vol. 167, no. 3, pp. 545-50.e1-2. https://doi.org/10.1016/j.jpeds.2015.06.012

TY - JOUR

T1 - Automated versus Manual Oxygen Control with Different Saturation Targets and Modes of Respiratory Support in Preterm Infants

AU - van Kaam, Anton H.

AU - Hummler, Helmut D.

AU - Wilinska, Maria

AU - Swietlinski, Janusz

AU - Lal, Mithilesh K.

AU - te Pas, Arjan B.

AU - Lista, Gianluca

AU - Gupta, Samir

AU - Fajardo, Carlos A.

AU - Onland, Wes

AU - Waitz, Markus

AU - Warakomska, Malgorzata

AU - Cavigioli, Francesco

AU - Bancalari, Eduardo

AU - Claure, Nelson

AU - Bachman, Thomas E.

PY - 2015

Y1 - 2015

N2 - To determine the efficacy and safety of automated adjustment of the fraction of inspired oxygen (FiO2) in maintaining arterial oxygen saturation (SpO2) within a higher (91%-95%) and a lower (89%-93%) target range in preterm infants. Eighty preterm infants (gestational age [median]: 26 weeks, age [median] 18 days) on noninvasive (n = 50) and invasive (n = 30) respiratory support with supplemental oxygen, were first randomized to one of the SpO2 target ranges and then treated with automated FiO2 (A-FiO2) and manual FiO2 (M-FiO2) oxygen control for 24 hours each, in random sequence. The percent time within the target range was higher during A-FiO2 compared with M-FiO2 control. This effect was more pronounced in the lower SpO2 target range (62 ± 17% vs 54 ± 16%, P < .001) than in the higher SpO2 target range (62 ± 17% vs 58 ± 15%, P < .001). The percent time spent below the target or in hypoxemia (SpO2 <80%) was consistently reduced during A-FiO2, independent of the target range. The time spent above the target range or at extreme hyperoxemia (SpO2 >98%) was only reduced during A-FiO2 when targeting the lower SpO2 range (89%-93%). These outcomes did not differ between infants on noninvasive and invasive respiratory support. Manual adjustments were significantly reduced during A-FiO2 control. A-FiO2 control improved SpO2 targeting across different SpO2 ranges and reduced hypoxemia in preterm infants on noninvasive and invasive respiratory support. ISRCTN 56626482

AB - To determine the efficacy and safety of automated adjustment of the fraction of inspired oxygen (FiO2) in maintaining arterial oxygen saturation (SpO2) within a higher (91%-95%) and a lower (89%-93%) target range in preterm infants. Eighty preterm infants (gestational age [median]: 26 weeks, age [median] 18 days) on noninvasive (n = 50) and invasive (n = 30) respiratory support with supplemental oxygen, were first randomized to one of the SpO2 target ranges and then treated with automated FiO2 (A-FiO2) and manual FiO2 (M-FiO2) oxygen control for 24 hours each, in random sequence. The percent time within the target range was higher during A-FiO2 compared with M-FiO2 control. This effect was more pronounced in the lower SpO2 target range (62 ± 17% vs 54 ± 16%, P < .001) than in the higher SpO2 target range (62 ± 17% vs 58 ± 15%, P < .001). The percent time spent below the target or in hypoxemia (SpO2 <80%) was consistently reduced during A-FiO2, independent of the target range. The time spent above the target range or at extreme hyperoxemia (SpO2 >98%) was only reduced during A-FiO2 when targeting the lower SpO2 range (89%-93%). These outcomes did not differ between infants on noninvasive and invasive respiratory support. Manual adjustments were significantly reduced during A-FiO2 control. A-FiO2 control improved SpO2 targeting across different SpO2 ranges and reduced hypoxemia in preterm infants on noninvasive and invasive respiratory support. ISRCTN 56626482

U2 - https://doi.org/10.1016/j.jpeds.2015.06.012

DO - https://doi.org/10.1016/j.jpeds.2015.06.012

M3 - Article

C2 - 26144575

SN - 0022-3476

VL - 167

SP - 545-50.e1-2

JO - Journal of pediatrics

JF - Journal of pediatrics

IS - 3

ER -