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.