Closed-loop automated oxygen control in late preterm and term, ventilated infants: A randomised controlled trial

To compare the time spent above the target oxygen saturation range (SpO₂ > 96%) and the duration of supplemental oxygen between ventilated infants receiving closed-loop automated oxygen control (CLAC) or manual oxygen control in late preterm and term ventilated infants.

Infants were randomised to receive CLAC or manual oxygen control from recruitment and within 24 h of mechanical ventilation until successful extubation.

Forty infants with a median (IQR) gestational age of 37.4 (35.9-38.5) weeks were studied at a corrected postmenstrual age of 37.6 (36.0-38.7) weeks. In infants randomised to CLAC (n = 18) the time spent above the target oxygen saturation range was reduced by 20% (p < 0.001), and the time spent in the target range (92%-96%) was increased by 32% (p < 0.001) and the time spent in hyperoxia was reduced (p = 0.003). CLAC reduced the time spent in hypoxemia (SpO₂ < 85%) (p = 0.017) and there were fewer manual adjustments to the inspired oxygen concentration (FiO₂) (p < 0.001). There was no significant difference in the duration of supplemental oxygen (p = 0.271).

CLAC in ventilated infants born at or near term was associated with reduced time spent in hyperoxemia, more time spent in the target oxygen range, and fewer manual adjustments to the FiO₂.