Closed-loop controlled inspired oxygen concentration for mechanically ventilated very low birth weight infants with frequent episodes of hypoxemia

Pediatrics
Nelson ClaureEduardo Bancalari

Abstract

Mechanically ventilated very low birth weight infants often present with frequent episodes of hypoxemia, and maintaining arterial oxygen saturation by pulse oximetry (SpO(2)) within a normal range by manual fraction of inspired oxygen (FIO(2)) adjustments is difficult and time consuming. An algorithm for closed-loop FIO(2) control (cFIO(2)) to maintain SpO(2) within a target range was compared with continuous manual FIO(2) (mFIO(2)) adjustments by a nurse in a group of ventilated infants who presented with frequent episodes of hypoxemia. Fourteen infants (birth weight: 712 +/- 142 g; gestational age: 25 +/- 1.6 weeks; age: 26 +/- 11 days; synchronized intermittent mandatory ventilation rate: 24 +/- 10 b/m; peak inspiratory pressure: 17.5 +/- 2.0 cmH(2)O; positive end-expiratory pressure: 4.3 +/- 0.5 cmH(2)O) were studied for 2 hours on each mode in random sequence. Both modes aimed to maintain SpO(2) between 88% and 96%. There were 15 +/- 7 and 16 +/- 6 hypoxemic episodes/hour (SpO(2) <88%, >5 s) during mFIO(2) and cFIO(2), respectively; episode duration was 41 +/- 23 and 32 +/- 15 s, totaling 19 +/- 16% and 17 +/- 12% of recording time. There were 13 +/- 10 and 10 +/- 8 hyperoxemic episodes/hour (SpO(2)>96%, >5 s) during mFIO(...Continue Reading

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