Background Preterm infants spend only 50% of time within the target oxygen saturation (SpO2) during manual FiO2 control (M-FiO2). Automated FiO2 control (A-FiO2) improves SpO2 targeting but it is uncertain if this applies to different SpO2 target ranges and during non-invasive support (NIVS) and mechanical ventilation (MV).
Objective To compare the efficacy of A-FiO2 vs M-FiO2 in keeping two different SpO2 targets during NIVS or MV.
Design/methods Preterm infants on FiO2 >0.21 receiving NIVS or MV were randomised to SpO2 targets 89–93% or 91–95% and underwent M-FiO2 and A-FiO2 for 24 h each, in random sequence.
Results 80 infants (GA:26 w, age:18 d) were included (NIVS = 48, MV = 32). Time within target increased and below target decreased during A-FiO2 compared with M-FiO2, especially in the lower target range. There was a reduction in time and hypoxemia episodes with SpO2 < 80% during A-FiO2. Outcomes did not differ between NIVS or MV.
Conclusions Automated FiO2 control improved SpO2 targeting across different SpO2 ranges and reduced hypoxemia with less workload during both NIVS and MV.