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  • Comparison of two automated oxygen controllers in oxygen targeting in preterm infants during admission: an observational study

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Original research
Comparison of two automated oxygen controllers in oxygen targeting in preterm infants during admission: an observational study
  1. Hylke H Salverda1,2,
  2. Janneke Dekker1,
  3. Enrico Lopriore1,
  4. Peter A Dargaville2,3,
  5. Steffen C Pauws1,4,
  6. Arjan B te Pas1
  1. 1 Willem-Alexander Children’s Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, The Netherlands, Leiden University Medical Center, Leiden, The Netherlands
  2. 2 Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
  3. 3 Department of Pediatrics, Royal Hobart Hospital, Hobart, Tasmania, Australia
  4. 4 Tilburg Center for Cognition and Communication, Tilburg University, Tilburg, The Netherlands
  1. Correspondence to Dr Hylke H Salverda, Department of Paediatrics, Leiden University Medical Center, Leiden 2333 ZA, Netherlands; H.H.Salverda{at}lumc.nl

Abstract

Objective To compare the effect of two different automated oxygen control devices on time preterm infants spent in different oxygen saturation (SpO2) ranges during their entire stay in the neonatal intensive care unit (NICU).

Design Retrospective cohort study of prospectively collected data.

Setting Tertiary level neonatal unit in the Netherlands.

Patients Preterm infants (OxyGenie 75 infants, CLiO2 111 infants) born at 24–29 weeks’ gestation receiving at least 72 hours of respiratory support between October 2015 and November 2020.

Interventions Inspired oxygen concentration was titrated by the OxyGenie controller (SLE6000 ventilator) between February 2019 and November 2020 and the CLiO2 controller (AVEA ventilator) between October 2015 and December 2018 as standard of care.

Main outcome measures Time spent within SpO2 target range (TR, 91–95% for either epoch) and other SpO2 ranges.

Results Time spent within the SpO2 TR when receiving supplemental oxygen was higher during OxyGenie control (median 71.5 [IQR 64.6–77.0]% vs 51.3 [47.3–58.5]%, p<0.001). Infants under OxyGenie control spent less time in hypoxic and hyperoxic ranges (SpO2<80%: 0.7 [0.4–1.4]% vs 1.2 [0.7–2.3]%, p<0.001; SpO2>98%: 1.0 [0.5–2.4]% vs 4.0 [2.0–7.9]%, p<0.001). Both groups received a similar FiO2 (29.5 [28.0–33.2]% vs 29.6 [27.7–32.1]%, p=not significant).

Conclusions Oxygen saturation targeting was significantly different in the OxyGenie epoch in preterm infants, with less time in hypoxic and hyperoxic SpO2 ranges during their stay in the NICU.

  • neonatology
  • respiratory medicine

Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/archdischild-2022-324819

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    Data availability statement

    Data are available on reasonable request.

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    • Contributors HHS co-conceived the study (with ABtP); conducted the study; compiled, analysed and interpreted the data (with SCP); co-wrote the first draft of the manuscript; and approved the final version of the manuscript. JD reviewed and edited the manuscript, acquired data and approved the final version of the manuscript. EL reviewed and edited the manuscript, acquired data and approved the final version of the manuscript. PAD interpreted the data, reviewed and edited the manuscript, and approved the final version of the manuscript. SCP reviewed and edited the manuscript, co-performed the analysis and interpretation of the data, and approved the final version of the manuscript. ABtP is guarantor of the study, co-conceived the study, oversaw the study conduct, interpreted the data, co-wrote the first draft of the manuscript and approved the final version.

    • Funding This work was supported by SLE Limited by an unrestricted research grant.

    • Disclaimer SLE Limited had no role in study design nor in the collection, analysis and interpretation of data, writing of the report and decision to submit the paper for publication.

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

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