https://orcid.org/0000-0003-4837-5445
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Abstract
Background
Ventilated preterm infants are exposed to deviations from the intended arterial oxygen saturation range. Therefore, an automated control system was developed to rapidly modulate the fraction of inspired oxygen. The aim of this review is to compare the efficacy and safety of automated versus manual oxygen delivery control.
Methods
In December 2020, we systematically searched four electronic databases; PubMed, Cochrane Library, Scopus, and Web of Science for eligible randomized controlled trials. We extracted and pooled data as mean difference and 95% confidence interval in an inverse variance method using RevMan software.
Results
Thirteen trials were included in this systematic review and meta-analysis, enrolling 343 preterm infants on respiratory support. Automated oxygen control increased the time spent within the target arterial oxygen saturation range of 85–96% (MD = 8.96; 95% CI [6.26, 11.67], p<.00001), and 90–95% (MD = 18.25; 95% CI [4.58, 31.65], p = .008). In addition, it reduced the time of hypoxia (<80%); (MD = –1.24; 95% CI [–2.05, −0.43], p = .003), (MD = –0.82; 95% CI [–1.23, −0.41], p<.0001) with predetermined ranges of 85–96% and 90–95%, respectively. Automated control system reduced as well the time of hyperoxia (>98%) (MD = –0.99; 95% CI [–1.74, −0.25], p = .009) at intended range of 90–95%, and number of manual inspired oxygen fraction adjustments (MD = –2.82; 95% CI [–4.56, −1.08], p = .002).
Conclusions
Automated oxygen delivery is rapid and effective in controlling infants' oxygen saturation. It can be used to reduce the load over the nurses, but not to substitute the clinical supervision. Further long-term trials of large-scale are required to evaluate the prolonged clinical outcomes.
Acknowledgements
We would like to acknowledge our colleges in the International Medical Research Association (IMedRA) for their continuous efforts and support.
Disclosure statement
No potential conflict of interest was reported by the author(s).