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Automated oxygen control in preterm infants, how does it work and what to expect: a narrative review
  1. Hylke H Salverda1,
  2. Sophie J E Cramer1,
  3. Ruben S G M Witlox1,
  4. Peter A Dargaville2,3,
  5. Arjan B te Pas1
  1. 1 Neonatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
  2. 2 Department of Pediatrics, Royal Hobart Hospital, Hobart, Tasmania, Australia
  3. 3 Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
  1. Correspondence to Dr Hylke H Salverda, Neonatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands; H.H.Salverda{at}


Background Automated oxygen control systems are finding their way into contemporary ventilators for preterm infants, each with its own algorithm, strategy and effect.

Objective To provide guidance to clinicians seeking to comprehend automated oxygen control and possibly introduce this technology in their practice.

Method A narrative review of the commercially available devices using different algorithms incorporating rule-based, proportional-integral-derivative and adaptive concepts are described and explained. An overview of how they work and, if available, the clinical effect is given.

Results All algorithms have shown a beneficial effect on the proportion of time that oxygen saturation is within target range, and a decrease in hyperoxia and severe hypoxia. Automated oxygen control may also reduce the workload for bedside staff. There is concern that such devices could mask clinical deterioration, however this has not been reported to date.

Conclusions So far, trials involving different algorithms are heterogenous in design and no head-to-head comparisons have been made, making it difficult to differentiate which algorithm is most effective and what clinicians can expect from algorithms under certain conditions.

  • technology
  • paediatric practice
  • intensive care
  • neonatology
  • respiratory

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  • Contributors Conception: HS, ABtP, PAD. Literature search: HS. Drafting of the manuscript: HS, SJEC, ABtP. Critical revision of the manuscript: HS, SJEC, RSGMW, PAD, ABtP. Final approval of the manuscript: HS, SJEC, RSGMW, PAD, ABtP.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests HHS has received an unrestricted research grant from SLE. The University of Tasmania and Royal Hobart Hospital have jointly lodged a patent application concerning automated control of inspired oxygen concentration in the newborn infant and have a licensing agreement with SLE in relation to OxyGenie automated oxygen control software.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this study. No data are available.

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