Clinical outcomes of preterm infants while using automated controllers during standard care: comparison of cohorts with different automated titration strategies

Hylke H Salverda; Dianthe M L Beelen; Sophie J E Cramer; Steffen C Pauws; Nicoline Schalij-Delfos; Arjan B Te Pas

doi:10.1136/archdischild-2021-323690

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 Jan;108(1):26-30. doi: 10.1136/archdischild-2021-323690. Epub 2022 May 16.

Authors

Hylke H Salverda¹, Dianthe M L Beelen², Sophie J E Cramer³, Steffen C Pauws^{2

4}, Nicoline Schalij-Delfos⁵, Arjan B Te Pas³

Affiliations

¹ Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands H.H.Salverda@lumc.nl.
² Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands.
³ Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
⁴ Tilburg center for Cognition and Communication, Tilburg University, Tilburg, The Netherlands.
⁵ Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands.

PMID: 35577567
DOI: 10.1136/archdischild-2021-323690

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.

Keywords: intensive care units, neonatal; neonatology; ophthalmology; respiratory.

Publication types

Observational Study

MeSH terms

Bronchopulmonary Dysplasia* / epidemiology
Female
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature
Male
Oxygen
Retinopathy of Prematurity*
Retrospective Studies

Substances

Oxygen