Automated oxygen flow titration for infants with bronchiolitis: a multicentre randomised controlled trial.

Area of Science:

• Pediatrics
• Respiratory Medicine
• Medical Technology

Background:

• Bronchiolitis is a common respiratory infection in infants.
• Oxygen therapy is frequently required for infants hospitalized with bronchiolitis.
• Current oxygen therapy is often manually controlled, leading to potential fluctuations in oxygen levels.

Purpose of the Study:

• To compare automated closed-loop oxygen therapy using the FreeO2 device with conventional manual oxygen therapy.
• To evaluate the impact on length of hospital stay in spontaneously breathing infants with bronchiolitis.

Main Methods:

• A multicentre randomized controlled trial involving 103 infants (1-12 months) with bronchiolitis requiring oxygen therapy.
• Infants were randomized to receive either automated (FreeO2 device) or manual oxygen administration.
• Primary endpoint: length of hospital stay; secondary endpoints included re-hospitalisation, NIV use, and time in hypoxia/hyperoxia.

Main Results:

• No significant difference in median hospital stay between the FreeO2 group (71.00 hours) and the manual group (69.6 hours).
• The FreeO2 group spent a significantly higher percentage of time within the target oxygen saturation zone (89.4% vs 74.9%).
• Median oxygen flow rate was significantly lower in the FreeO2 group (0.1 L/min vs 0.3 L/min).

Conclusions:

• Automated closed-loop oxygen therapy with the FreeO2 device did not reduce length of hospital stay in infants with bronchiolitis.
• The FreeO2 device demonstrated a significant reduction in oxygen flow rates and improved time within the target oxygen saturation zone.
• Low study recruitment may have impacted the ability to detect a difference in length of stay.