A randomised crossover trial of closed loop automated oxygen control in preterm, ventilated infants

2020 ◽  
Author(s):  
Sarah Sturrock ◽  
Hemant Ambulkar ◽  
Emma E. Williams ◽  
Samantha Sweeney ◽  
Nadja F. Bednarczuk ◽  
...  
Keyword(s):  
Closed Loop ◽  
Crossover Trial ◽  
Oxygen Control ◽  
Automated Oxygen Control

scholarly journals Closed loop automated oxygen control in neonates—A review

2019 ◽  
Vol 109 (5) ◽  
pp. 914-922 ◽  
Author(s):  
Sarah Sturrock ◽  
Emma Williams ◽  
Theodore Dassios ◽  
Anne Greenough
Keyword(s):  
Closed Loop ◽  
Oxygen Control ◽  
Automated Oxygen Control

Closed loop automated oxygen control in optimisation of mechanical ventilation in preterm infants

2020 ◽  
Author(s):  
Hemant Ambulkar ◽  
Sarah Sturrock ◽  
Samantha Sweeney ◽  
Nadja Bednarczuk ◽  
Emma Williams ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Preterm Infants ◽  
Closed Loop ◽  
Oxygen Control ◽  
Automated Oxygen Control

Closed-Loop Oxygen Control Using a Novel Nasal High-Flow Device: A Randomized Crossover Trial

2020 ◽  
pp. respcare.08087
Author(s):  
James CP Harper ◽  
Nethmi A Kearns ◽  
Ingrid Maijers ◽  
Grace E Bird ◽  
Irene Braithwaite ◽  
...  
Keyword(s):  
Closed Loop ◽  
Crossover Trial ◽  
High Flow ◽  
Oxygen Control ◽  
Randomized Crossover Trial ◽  
Flow Device

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.

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