Automatic oxygen control for reducing extremes of oxygen saturation: a randomised controlled trial

Area of Science:

• Neonatal Medicine
• Pediatric Respiratory Care
• Medical Technology

Background:

• Preterm infants often experience hypoxemia during respiratory support.
• Maintaining optimal oxygen saturation is critical for preventing complications in neonates.
• Current methods of oxygen control may lead to suboptimal oxygenation.

Purpose of the Study:

• To evaluate the efficacy of automatic oxygen control (A-FiO2) versus manual oxygen control (M-FiO2).
• To assess the reduction in severe hypoxemia (SpO2 <80%) in preterm infants.
• To determine the impact on infants receiving invasive ventilation or nasal CPAP via AVEA ventilator.

Main Methods:

• A parallel-arm randomized controlled trial conducted in a level-III NICU.
• Inclusion of preterm infants (<33 weeks gestation) requiring respiratory support within 72 hours of age.
• Comparison of A-FiO2 with M-FiO2 for oxygen management.

Main Results:

• 44 infants were randomized; 194 study days in A-FiO2 arm, 204 in M-FiO2 arm.
• A-FiO2 significantly reduced time spent in severe hypoxemia (0.1% vs 0.6%, p=0.03).
• Prolonged episodes of severe hypoxemia per day were also significantly lower with A-FiO2 (0.3 vs 2, p=0.02).

Conclusions:

• Automatic oxygen control (A-FiO2) is effective in reducing severe hypoxemia in preterm infants.
• A-FiO2 offers a statistically significant improvement over manual oxygen control (M-FiO2).
• This technology enhances respiratory support management for vulnerable neonates.