Background The risks associated with hyperoxia as well as hypoxia, particularly in the preterm newborn, are well described. Although it is the standard of care for ventilated infants requiring supplemental oxygen to maintain oxygen saturation (SpO₂) within ‘optimal target range’, it may only be achieved for about 50% of the time. Routinely, inspired oxygen (FiO₂) is adjusted manually but it is now possible to have automated control by using a device (CLiO₂™) incorporated in Avea ventilator. One study using such device, carried out in the USA showed improvement in maintaining SpO₂ within the target range¹ but no further study has been reported to date since the oximeters have been upgraded with new algorithm.

Objective To evaluate the efficacy of the automatic FiO₂ control function in the Avea ventilator in comparison to manual FiO₂ control during routine care in maintaining target ranges of SpO₂ between 90–95% using a randomised crossover design in ventilated infants requiring supplemental oxygen therapy.

Methods Thirty infants (gestational age [median and interquartile range]: 26 weeks [24–27 weeks]; age: 13.5 days [9–26 days]) were studied during 2 consecutive 12-hour periods, one with FiO₂ adjustment by clinical team (manual) and the other by an automated system (automated), in a random sequence at the tertiary NICU in the UK between Feb 2012 and Aug 2013.

Results Of the 27 infants completing the study, improved compliance with allocated target range was noted in 23 (85%) during the automated control of inspired oxygen.

Conclusions Automated control of FiO₂ allowed significantly improved compliance of oxygen saturation within a desired target range and significantly reduced exposure to hypoxia as well as hyperoxia in ventilated newborn infants requiring supplemental oxygen.

Reference 1 Claure et al Paediatrics 2011; 127:e76-e83