The Journal of Pediatrics
Volume 155, Issue 5 , Pages 640-645.e2 , November 2009

Automated Adjustment of Inspired Oxygen in Preterm Infants with Frequent Fluctuations in Oxygenation: A Pilot Clinical Trial

  • Nelson Claure, MSc, PhD

      Affiliations

    • Corresponding Author InformationReprint requests: Nelson Claure, Division of Neonatology, Department of Pediatrics, University of Miami School of Medicine, PO Box 016960 R-131, Miami, FL 33101.
  • ,
  • Carmen D'Ugard, RRT
  • ,
  • Eduardo Bancalari, MD

Received 16 December 2008 ,Revised 31 March 2009 ,Accepted 24 April 2009.

References 

  1. McColm JR, Fleck BW. Retinopathy of prematurity: causation. Semin Neonatol. 2001;6:453–460
  2. Tin W, Gupta S. Optimum oxygen therapy in preterm babies. Arch Dis Child Fetal Neonatal Ed. 2007;92:F143–F147
  3. Saugstad OD. Bronchopulmonary dysplasia-oxidative stress and oxidants. Semin Neonatol. 2003;8:39–49
  4. Hagadorn JI, Furey AM, Nghiem TH, Schmid CH, Phelps DL, Pillers DA, et al. AVIOx Study Group. Achieved versus intended pulse oximeter saturation in infants born less than 28 weeks' gestation: the AVIOx study. Pediatrics. 2006;118:1574–1582
  5. Laptook AR, Salhab W, Allen J, Saha S, Walsh M. Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?. J Perinatol. 2006;26:337–341
  6. Bolivar JM, Gerhardt T, Gonzalez A, Hummler H, Claure N, Everett R, et al. Mechanisms for episodes of hypoxemia in preterm infants undergoing mechanical ventilation. J Pediatr. 1995;127:767–773
  7. Esquer C, Claure N, D'Ugard C, Wada Y, Bancalari E. The role of abdominal muscle activity on the duration and severity of hypoxemia episodes in mechanically ventilated preterm infants. Neonatology. 2007;92:182–186
  8. Dimaguila MA, DiFiore JA, Martin R, Miller MJ. Characteristics of hypoxemic episodes in very low birth weight infants on ventilatory support. J Pediatr. 1997;130:577–583
  9. McEvoy C, Durand M, Hewlett V. Episodes of spontaneous desaturations in infants with chronic lung disease at two different levels of oxygenation. Pediatr Pulmonol. 1993;15:140–144
  10. Beddis JR, Collins P, Levy NM, Godfrey S, Silverman M. New technique for servo-control of arterial oxygen tension in preterm infants. Arch Dis Child. 1979;54:278–280
  11. Dugdale RE, Cameron RG, Lealman GT. Closed-loop control of the partial pressure of arterial oxygen in neonates. Clin Physics Physiol Meas. 1988;9:291–305
  12. Bhutani VK, Taube JC, Antunes MJ, Delivoria-Papadopoulos M. Adaptive control of the inspired oxygen delivery to the neonate. Pediatr Pulmonol. 1992;14:110–117
  13. Morozoff PE, Evans RW. Closed-loop control of SaO2 in the neonate. Biomed Instrum Technol. 1992;26:117–123
  14. Sun Y, Kohane IS, Stark AR. Computer-assisted adjustment of inspired oxygen concentration improves control of oxygen saturation in newborn infants requiring mechanical ventilation. J Pediatr. 1997;131:754–756
  15. Claure N, Gerhardt T, Everett R, Musante G, Herrera C, Bancalari E. Closed-loop controlled inspired oxygen concentration for mechanically ventilated very low birth weight infants with frequent episodes of hypoxemia. Pediatrics. 2001;107:1120–1124
  16. Urschitz MS, Horn W, Seyfang A, Hallenberger A, Herberts T, Miksch S, et al. Automatic control of the inspired oxygen fraction in preterm infants: a randomized crossover trial. Am J Respir Crit Care Med. 2004;170:1095–1100
  17. Saugstad OD. Oxygen radical disease in neonatology. Semin Neonatol. 1998;3:229–238

 Supported by Viasys Healthcare, The University of Miami “Project: New Born,” and The Bank of America Charitable Foundation. Presented in part at the 2007 meeting of the Society for Pediatric Research. The authors have a patent on the algorithm used to automatically adjust the inspired oxygen. The University of Miami, the assignee for this patent, has a license agreement with Viasys Healthcare. Viasys Healthcare and Masimo Corporation have supported post-graduate educational activities at the University of Miami.

PII: S0022-3476(09)00453-3

doi: 10.1016/j.jpeds.2009.04.057

The Journal of Pediatrics
Volume 155, Issue 5 , Pages 640-645.e2 , November 2009