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Automated oxygen control for very preterm infants and neurodevelopmental outcome at 2 years-a retrospective cohort

Hylke H Salverda1, N Nathalie J Oldenburger2, Monique Rijken2

  • 1Department of Paediatrics, Division of Neonatology, Willem-Alexander Children's Hospital, Leiden University Medical Center, PO Box 9600, Leiden, the Netherlands. H.H.Salverda@lumc.nl.

European Journal of Pediatrics
|January 24, 2023
PubMed

Insights

Automated oxygen control (AOC) in preterm infants did not significantly change neurodevelopmental outcomes at two years. This study found no difference in mortality or severe impairment after implementing AOC as standard NICU care.

Area of Science:

  • Neonatal care
  • Pediatric neurodevelopment
  • Respiratory support

Background:

  • Hypoxemia and hyperoxaemia in preterm infants are linked to neurodevelopmental impairment.
  • Automated oxygen control (AOC) may improve oxygen saturation stability.
  • Faster resolution of oxygen events could reduce long-term impairment.

Purpose of the Study:

  • To compare neurodevelopmental outcomes at two years of age in preterm infants before and after the implementation of automated oxygen control (AOC).
  • To assess the impact of AOC on mortality, severe and mild-moderate neurodevelopmental impairment, and other developmental outcomes.

Main Methods:

  • A cohort study comparing preterm infants (24-29 weeks gestational age) before (2012-2015) and after (2015-2018) AOC implementation.
  • Neurodevelopmental outcomes, including mortality, severe/mild-moderate impairment, cerebral palsy, and behavioral scores, were assessed at two years.
  • A total of 581 infants were included (289 pre-AOC, 292 post-AOC).

Main Results:

  • No statistically significant difference was found in the composite outcome of mortality or severe neurodevelopmental impairment (17.9% pre-AOC vs. 24.0% post-AOC, p=0.12).
  • Secondary outcomes including mild-moderate NDI, Bayley-III scores, and cerebral palsy (GMFCS) also showed no significant differences.
  • Parent-reported readmissions were less frequent in the post-AOC group.

Conclusions:

  • Implementation of automated oxygen control as standard care in a NICU did not lead to a statistically significant difference in neurodevelopmental outcomes at two years of age for preterm infants.
  • While AOC did not alter primary neurodevelopmental outcomes, it was associated with fewer readmissions.

Keywords:
AlgorithmClosed-loopFollow-upHyperoxiaHypoxemiaNeonateRespiratory

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