Salverda HH, Beelen DML, Cramer SJE, Pauws SC, Schalij-Delfos N, Te Pas AB. Clinical outcomes of preterm infants while using automated controllers during standard care: comparison of cohorts with different automated titration strategies.
Arch Dis Child Fetal Neonatal Ed 2023;
108:26-30. [PMID:
35577567 DOI:
10.1136/archdischild-2021-323690]
[Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/30/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE
To compare short-term clinical outcome after using two different automated oxygen controllers (OxyGenie and CLiO2).
DESIGN
Propensity score-matched retrospective observational study.
SETTING
Tertiary-level neonatal unit in the Netherlands.
PATIENTS
Preterm infants (OxyGenie n=121, CLiO2 n=121) born between 24+0-29+6 weeks of gestation. Median (IQR) gestational age in the OxyGenie cohort was 28+3 (26+3.5-29+0) vs 27+5 (26+5-28+3) in the CLiO2 cohort, respectively 42% and 46% of infants were male and mean (SD) birth weight was 1034 (266) g vs 1022 (242) g.
INTERVENTIONS
Inspired oxygen was titrated by OxyGenie (SLE6000) or CLiO2 (AVEA) during respiratory support.
MAIN OUTCOME MEASURES
Mortality, retinopathy of prematurity (ROP), bronchopulmonary dysplasia and necrotising enterocolitis.
RESULTS
Fewer infants in the OxyGenie group received laser coagulation for ROP (1 infant vs 10; risk ratio 0.1 (95% CI 0.0 to 0.7); p=0.008), and infants stayed shorter in the neonatal intensive care unit (NICU) (28 (95% CI 15 to 42) vs 40 (95% CI 25 to 61) days; median difference 13.5 days (95% CI 8.5 to 19.5); p<0.001). Infants in the OxyGenie group had fewer days on continuous positive airway pressure (8.4 (95% CI 4.8 to 19.8) days vs 16.7 (95% CI 6.3 to 31.1); p<0.001) and a significantly shorter days on invasive ventilation (0 (95% CI 0 to 4.2) days vs 2.1 (95% CI 0 to 8.4); p=0.012). There were no statistically significant differences in all other morbidities.
CONCLUSIONS
In this propensity score-matched retrospective study, the OxyGenie epoch was associated with less morbidity when compared with the CLiO2 epoch. There were significantly fewer infants that received treatment for ROP, received less intensive respiratory support and, although there were more supplemental oxygen days, the duration of stay in the NICU was shorter. A larger study will have to replicate these findings.
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