Acta Paediatr

. 2023 Jan 19.

 doi: 10.1111/apa.16678. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/36656138/

Closed-loop oxygen system in late preterm/term, ventilated infants with different severities of respiratory disease

Ourania Kaltsogianni ¹, Theodore Dassios ^1 2, Christopher Harris ², Allan Jenkinson ¹, Rebecca Ann Lee ¹, Masashiro Sugino ³, Anne Greenough ¹

Affiliations expand

• PMID: 36656138
• DOI: 10.1111/apa.16678

Abstract

Aim: To evaluate closed-loop automated oxygen control (CLAC) in ventilated infants >33 weeks of gestation with different respiratory disease severities.

Methods: Infants were studied on two consecutive days for six hours each day. They were randomised to receive standard care or standard care with CLAC (Oxygenie) first. Analyses were performed of the results of infants with or without an FiO₂ ≥0.3 and infants with congenital diaphragmatic hernia (CDH).

Results: Thirty-one infants with a median (IQR) gestational age of 37.9 (37.1-38.9) weeks were studied at a median postmenstrual age (IQR) of 38.9 (37.4-39.8) weeks. In infants with an FiO₂ ≥ 0.3 (n=8), CLAC increased the time spent in target oxygen range (92-96%) by 61.6% (p=0.018) whereas in infants with an FiO₂ <0.3 the time in target was increased by 3.8% (p=0.019). During CLAC, only infants with an FiO₂ ≥0.3 spent less time in hyperoxemia (SpO₂ > 96%) (p=0.012) and hyperoxemic episodes were shorter (p=0.012). In both groups, CLAC reduced the duration of desaturations (SpO₂ <92%, p<.001). In CDH infants, CLAC increased the time spent in target oxygen range by 34% (p=0.036) and the median duration of desaturations was reduced (p=0.028).

Conclusion: CLAC may be more useful in infants with more severe respiratory distress.

Keywords: Closed-loop automated oxygen delivery; congenital diaphragmatic hernia; term infant.

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