Automated control of oxygen titration in preterm infants on non-invasive respiratory support
| Autor: | Oliver J Ladlow, Caillin Eastwood-Sutherland, Andrew P. Marshall, Kathleen Lim, Timothy J. Gale, Rohan Jayakar, Peter A. Dargaville, Sanoj K M Ali, Charlotte Bannink |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Neonatal intensive care unit chemistry.chemical_element Oxygen 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Intensive Care Units Neonatal medicine Humans 030212 general & internal medicine Neonatology Prospective Studies Respiratory system Respiratory Distress Syndrome Newborn Cross-Over Studies Noninvasive Ventilation business.industry Non invasive Obstetrics and Gynecology General Medicine Automated control Respiratory support chemistry Oxygen Saturation Anesthesia Pediatrics Perinatology and Child Health Gestation business Algorithms Infant Premature |
| Zdroj: | Archives of disease in childhood. Fetal and neonatal edition. 107(1) |
| ISSN: | 1468-2052 |
| Popis: | ObjectiveTo evaluate the performance of a rapidly responsive adaptive algorithm (VDL1.1) for automated oxygen control in preterm infants with respiratory insufficiency.DesignInterventional cross-over study of a 24-hour period of automated oxygen control compared with aggregated data from two flanking periods of manual control (12 hours each).SettingNeonatal intensive care unit.ParticipantsPreterm infants receiving non-invasive respiratory support and supplemental oxygen; median birth gestation 27 weeks (IQR 26–28) and postnatal age 17 (12–23) days.InterventionAutomated oxygen titration with the VDL1.1 algorithm, with the incoming SpO2 signal derived from a standard oximetry probe, and the computed inspired oxygen concentration (FiO2) adjustments actuated by a motorised blender. The desired SpO2 range was 90%–94%, with bedside clinicians able to make corrective manual FiO2 adjustments at all times.Main outcome measuresTarget range (TR) time (SpO2 90%–94% or 90%–100% if in air), periods of SpO2 deviation, number of manual FiO2 adjustments and oxygen requirement were compared between automated and manual control periods.ResultsIn 60 cross-over studies in 35 infants, automated oxygen titration resulted in greater TR time (manual 58 (51–64)% vs automated 81 (72–85)%, p2 adjustments were infrequent during automated control (0.11 adjustments/hour), and oxygen requirements were similar (manual 28 (25–32)% and automated 26 (24–32)%, p=0.13).ConclusionThe VDL1.1 algorithm was safe and effective in SpO2 targeting in preterm infants on non-invasive respiratory support.Trial registration numberACTRN12616000300471. |
| Databáze: | OpenAIRE |
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