TY - JOUR T1 - Randomised crossover trial comparing algorithms and averaging times for automatic oxygen control in preterm infants JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed DO - 10.1136/archdischild-2021-322096 SP - fetalneonatal-2021-322096 AU - Christoph E Schwarz AU - Karen B Kreutzer AU - Lukas Langanky AU - Nicole S Wolf AU - Wolfgang Braun AU - Marc Paul O'Sullivan AU - Christian F Poets AU - Axel R Franz Y1 - 2021/11/24 UR - http://fn.bmj.com/content/early/2021/11/24/archdischild-2021-322096.abstract N2 - Objective Automatic control (SPOC) of the fraction of inspired oxygen (FiO2), based on continuous analysis of pulse oximeter saturation (SpO2), improves the proportion of time preterm infants spend within a specified SpO2-target range (Target%). We evaluated if a revised SPOC algorithm (SPOCnew, including an upper limit for FiO2) compared to both routine manual control (RMC) and the previously tested algorithm (SPOCold, unrestricted maximum FiO2) increases Target%, and evaluated the effect of the pulse oximeter’s averaging time on controlling the SpO2 signal during SPOC periods.Design Unblinded, randomised controlled crossover study comparing 2 SPOC algorithms and 2 SpO2 averaging times in random order: 12 hours SPOCnew and 12 hours SPOCold (averaging time 2 s or 8 s for 6 hours each) were compared with 6-hour RMC. A generated list of random numbers was used for allocation sequence.Setting University-affiliated tertiary neonatal intensive care unit, GermanyPatients Twenty-four infants on non-invasive respiratory support with FiO2 >0.21 were analysed (median gestational age at birth, birth weight and age at randomisation were 25.3 weeks, 585 g and 30 days).Main outcome measure Target%.Results Mean (SD) [95% CI] Target% was 56% (9) [52, 59] for RMC versus 69% (9) [65, 72] for SPOCold_2s, 70% (7) [67, 73] for SPOCnew_2s, 71% (8) [68, 74] for SPOCold_8s and 72% (8) [69, 75] for SPOCnew_8s.Conclusions Irrespective of SpO2-averaging time, Target% was higher with both SPOC algorithms compared to RMC. Despite limiting the maximum FiO2, SPOCnew remained significantly better at maintaining SpO2 within target range compared to RMC.Trial registration NCT03785899 Data are available on reasonable request. Additional data will be made available on reasonable request. ER -