Closed-loop automated oxygen control in ventilated infants born at or near term: A crossover trial

Aim: To determine if the use of closed-loop automated oxygen control (CLAC) reduced the incidence and duration of hypoxemic episodes (SpO(2) < 92%) in ventilated infants born at or above 34 weeks of gestation. Methods: Infants were studied on two consecutive days for 6 h each day. They were randomised to receive standard care (manual oxygen control) or standard care with a CLAC system (automated oxygen control) first. Results: Sixteen infants with a median (IQR) gestational age of 37.4 (36.6-38.8) weeks were studied at a median (IQR) postmenstrual age of 38.8 (37.4-39.8) weeks. During the automated oxygen control period, infants spent less time in hypoxemia (SpO(2) < 92%) (p = 0.033), episodes of desaturation were shorter (p = 0.001), the time spent within target SpO(2) range (92%-96%) was increased (p = 0.001), and the FiO(2) delivery was lower (p = 0.018). The time spent in hyperoxemia (SpO(2) > 96%) was reduced during automated oxygen control (p = 0.011), the episodes of hyperoxemia were of shorter duration (p = 0.008) and fewer manual adjustments were made to the FiO(2) (p = 0.005). Conclusions: Closed-loop automated oxygen control in ventilated infants born at or near term was associated with a reduction in the incidence and duration of hypoxemic episodes with more time spent in the target oxygen range.

Automated summary

This study aimed to determine if using closed-loop automated oxygen control (CLAC) can reduce the incidence and duration of hypoxemic episodes in ventilated infants born at or above 34 weeks of gestation. The results showed that CLAC resulted in less time spent in hypoxemia, shorter episodes of desaturation, increased time spent in the target SpO(2) range, and lower FiO(2) delivery. It also reduced time spent in hyperoxemia, shorter episodes of hyperoxemia, and fewer manual adjustments made to the FiO(2).