Automated control of inspired oxygen in ventilated preterm infants: crossover physiological study

2015 ◽  
Vol 104 (11) ◽  
pp. 1084-1089 ◽  
Author(s):  
Mithilesh Lal ◽  
Win Tin ◽  
Sunil Sinha
Keyword(s):  
Preterm Infants ◽  
Physiological Study ◽  
Automated Control ◽  
Inspired Oxygen

Multicenter Crossover Study of Automated Control of Inspired Oxygen in Ventilated Preterm Infants

PEDIATRICS ◽  
2010 ◽  
Vol 127 (1) ◽  
pp. e76-e83 ◽  
Author(s):  
N. Claure ◽  
E. Bancalari ◽  
C. D'Ugard ◽  
L. Nelin ◽  
M. Stein ◽  
...  
Keyword(s):  
Crossover Study ◽  
Preterm Infants ◽  
Automated Control ◽  
Inspired Oxygen

Automated control of inspired oxygen for preterm infants: What we have and what we need

2016 ◽  
Vol 28 ◽  
pp. 9-18 ◽  
Author(s):  
Omid Sadeghi Fathabadi ◽  
Timothy J. Gale ◽  
J.C. Olivier ◽  
Peter A. Dargaville
Keyword(s):  
Preterm Infants ◽  
Automated Control ◽  
Inspired Oxygen

Cerebral and splanchnic oxygenation during automated control of inspired oxygen (FiO 2 ) in preterm infants

2021 ◽  
Author(s):  
Carlo Dani ◽  
Simone Pratesi ◽  
Michele Luzzati ◽  
Chiara Petrolini ◽  
Simona Montano ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Automated Control ◽  
Splanchnic Oxygenation ◽  
Inspired Oxygen

Automated control of oxygen titration in preterm infants on non-invasive respiratory support

2021 ◽  
pp. fetalneonatal-2020-321538
Author(s):  
Peter A Dargaville ◽  
Andrew P Marshall ◽  
Oliver J Ladlow ◽  
Charlotte Bannink ◽  
Rohan Jayakar ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Supplemental Oxygen ◽  
Respiratory Support ◽  
Target Range ◽  
Manual Control ◽  
Oxygen Control ◽  
Automated Control ◽  
Non Invasive ◽  
Automated Oxygen Control

ObjectiveTo evaluate the performance of a rapidly responsive adaptive algorithm (VDL1.1) for automated oxygen control in preterm infants with respiratory insufficiency.DesignInterventional cross-over study of a 24-hour period of automated oxygen control compared with aggregated data from two flanking periods of manual control (12 hours each).SettingNeonatal intensive care unit.ParticipantsPreterm infants receiving non-invasive respiratory support and supplemental oxygen; median birth gestation 27 weeks (IQR 26–28) and postnatal age 17 (12–23) days.InterventionAutomated oxygen titration with the VDL1.1 algorithm, with the incoming SpO2 signal derived from a standard oximetry probe, and the computed inspired oxygen concentration (FiO2) adjustments actuated by a motorised blender. The desired SpO2 range was 90%–94%, with bedside clinicians able to make corrective manual FiO2 adjustments at all times.Main outcome measuresTarget range (TR) time (SpO2 90%–94% or 90%–100% if in air), periods of SpO2 deviation, number of manual FiO2 adjustments and oxygen requirement were compared between automated and manual control periods.ResultsIn 60 cross-over studies in 35 infants, automated oxygen titration resulted in greater TR time (manual 58 (51–64)% vs automated 81 (72–85)%, p<0.001), less time at both extremes of oxygenation and considerably fewer prolonged hypoxaemic and hyperoxaemic episodes. The algorithm functioned effectively in every infant. Manual FiO2 adjustments were infrequent during automated control (0.11 adjustments/hour), and oxygen requirements were similar (manual 28 (25–32)% and automated 26 (24–32)%, p=0.13).ConclusionThe VDL1.1 algorithm was safe and effective in SpO2 targeting in preterm infants on non-invasive respiratory support.Trial registration numberACTRN12616000300471.

Randomised cross-over study of automated oxygen control for preterm infants receiving nasal high flow

2018 ◽  
pp. fetalneonatal-2018-315342 ◽  
Author(s):  
Peter R Reynolds ◽  
Thomas L Miller ◽  
Leonithas I Volakis ◽  
Nicky Holland ◽  
George C Dungan ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Primary Outcome Measure ◽  
High Flow ◽  
Target Range ◽  
Manual Control ◽  
Oxygen Control ◽  
Automated Control ◽  
Registration Number ◽  
Preterm Babies

ObjectiveTo evaluate a prototype automated controller (IntellO2) of the inspired fraction of oxygen (FiO2) in maintaining a target range of oxygen saturation (SpO2) in preterm babies receiving nasal high flow (HF) via the Vapotherm Precision Flow.DesignProspective two-centre order-randomised cross-over study.SettingNeonatal intensive care units.PatientsPreterm infants receiving HF with FiO2 ≥25%.InterventionAutomated versus manual control of FiO2 to maintain a target SpO2 range of 90%–95% (or 90%–100% if FiO2=21%).Main outcome measuresThe primary outcome measure was per cent of time spent within target SpO2 range. Secondary outcomes included the overall proportion and durations of SpO2 within specified hyperoxic and hypoxic ranges and the number of in-range episodes per hour.ResultsData were analysed from 30 preterm infants with median (IQR) gestation at birth of 26 (24–27) weeks, study age of 29 (18–53) days and study weight 1080 (959–1443) g. The target SpO2 range was achieved 80% of the time on automated (IntellO2) control (IQR 70%–87%) compared with 49% under manual control (IQR 40%–57%; p<0.0001). There were fewer episodes of SpO2 below 80% lasting at least 60 s under automated control (0 (IQR 0–1.25)) compared with manual control (5 (IQR 2.75–14)). There were no differences in the number of episodes per hour of SpO2 above 98% (4.5 (IQR 1.8–8.5) vs 5.5 (IQR 1.9–14); p=0.572) between the study arms.ConclusionsThe IntellO2 automated oxygen controller maintained patients in the target SpO2 range significantly better than manual adjustments in preterm babies receiving HF.Trial registration numberNCT02074774.

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