| Autor: |
Hylke H. Salverda, N.Nathalie J. Oldenburger, Monique Rijken, R.Ratna N. G. B. Tan, Arjan B. te Pas, Jeanine M. M. van Klink |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
European Journal of Pediatrics. 182:1593-1599 |
| ISSN: |
1432-1076 |
| Popis: |
Faster resolution of hypoxaemic or hyperoxaemic events in preterm infants may reduce long-term neurodevelopmental impairment. Automatic titration of inspiratory oxygen increases time within the oxygen saturation target range and may provide a more prompt response to hypoxic and hyperoxic events. We assessed routinely performed follow-up at 2 years of age after the implementation of automated oxygen control (AOC) as standard care and compared this with a historical cohort. Neurodevelopmental outcomes at 2 years of age were compared for infants born at 24–29 weeks gestational age before (2012–2015) and after (2015–2018) the implementation of AOC as standard of care. The primary outcome was a composite outcome of either mortality or severe neurodevelopmental impairment (NDI), and other outcomes assessed were mild-moderate NDI, Bayley-III composite scores, cerebral palsy GMFCS, and CBCL problem behaviour scores. A total of 289 infants were included in the pre-AOC epoch and 292 in the post-AOC epoch. Baseline characteristics were not significantly different. Fifty-one infants were lost to follow-up (pre-AOC 6.9% (20/289), post-implementation 10.6% (31/292). The composite outcome of mortality or severe NDI was observed in 17.9% pre-AOC (41/229) vs. 24.0% (47/196) post-AOC (p = 0.12). No significant differences were found for the secondary outcomes such as mild-moderate NDI, Bayley-III composite scores, cerebral palsy GMFCS, and problem behaviour scores, with the exception of parent-reported readmissions until the moment of follow-up which was less frequent post-AOC than pre-AOC.Conclusion: In this cohort study, the implementation of automated oxygen control in our NICU as standard of care for preterm infants led to no statistically significant difference in neurodevelopmental outcome at 2 years of age. What is Known:• Neurodevelopmental outcome is linked to hypoxemia, hyperoxaemia and choice of SpO2 target range.• Automated titration of inspired oxygen may provide a faster resolution of hypoxaemic and hyperoxaemic events. What is New: • This cohort study did not find a significant difference in neurodevelopmental outcome at two years of age after implementing automated oxygen control as standard of care. |
| Databáze: |
OpenAIRE |
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