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Published on: August 19, 2020
Bedside algorithms for managing desaturation in ventilated preterm infants: a randomised crossover trial.
Dominic J Wilkinson1, Chad C Andersen
1The Ethox Centre, University of Oxford, Oxford, UK. dominic.wilkinson@ethox.ox.ac.uk
Neonatology
|December 10, 2008
Summary
Managing desaturation in preterm infants requires further study. Two bedside algorithms, one adjusting inspired oxygen (FiO2) and another ventilator pressures, showed no significant difference in improving oxygen saturation targets.
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Care
- Clinical Trial Design
Background:
- Desaturation episodes are frequent in preterm infants requiring mechanical ventilation.
- Optimal strategies for managing these desaturation events remain unclear.
Purpose of the Study:
- To compare the effectiveness of two bedside algorithms for managing desaturation episodes in ventilated preterm infants.
- To evaluate titration of inspired oxygen (FiO2) versus ventilator pressure adjustments.
Main Methods:
- A randomized crossover study involving 23 preterm infants (<32 weeks gestation).
- Infants were managed with two 8-hour periods using either FiO2 titration or ventilator pressure adjustments.
- Outcomes included time in target saturation band, desaturation frequency/duration, and a desaturation/oversaturation index.
Main Results:
- Infants achieved target saturation 51% of the time.
- The algorithm adjusting ventilator pressures involved more parameter changes.
- No significant differences were observed between the two algorithms in time within target saturation, desaturation frequency/duration, or the desaturation/oversaturation index.
Conclusions:
- Current bedside management algorithms for desaturation in ventilated preterm infants may not significantly differ in effectiveness.
- Further research is needed to establish optimal management protocols for these vulnerable infants.
