Automated oxygen control for very preterm infants and neurodevelopmental outcome at 2 years-a retrospective cohort study

被引:3
|
作者
Salverda, Hylke H. [1 ]
Oldenburger, N. Nathalie J. [1 ]
Rijken, Monique [1 ]
Tan, R. Ratna N. G. B. [1 ]
Pas, Arjan B. te [1 ]
van Klink, Jeanine M. M. [2 ]
机构
[1] Leiden Univ, Willem Alexander Childrens Hosp, Dept Paediat, Div Neonatol,Med Ctr, POB 9600, Leiden, Netherlands
[2] Leiden Univ, Willem Alexander Childrens Hosp, Dept Paediat, Div Psychol,Med Ctr, Leiden, Netherlands
关键词
Hypoxemia; Hyperoxia; Closed-loop; Algorithm; Neonate; Respiratory; Follow-up; INSPIRED OXYGEN; ADAPTIVE ALGORITHM; EPISODES; SATURATION; CROSSOVER;
D O I
10.1007/s00431-023-04809-4
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Faster resolution of hypoxaemic or hyperoxaemic events in preterm infants may reduce long-term neurodevelopmental impairment. Automatic titration of inspiratory oxygen increases time within the oxygen saturation target range and may provide a more prompt response to hypoxic and hyperoxic events. We assessed routinely performed follow-up at 2 years of age after the implementation of automated oxygen control (AOC) as standard care and compared this with a historical cohort. Neurodevelopmental outcomes at 2 years of age were compared for infants born at 24-29 weeks gestational age before (2012-2015) and after (2015-2018) the implementation of AOC as standard of care. The primary outcome was a composite outcome of either mortality or severe neurodevelopmental impairment (NDI), and other outcomes assessed were mild-moderate NDI, Bayley-III composite scores, cerebral palsy GMFCS, and CBCL problem behaviour scores. A total of 289 infants were included in the pre-AOC epoch and 292 in the post-AOC epoch. Baseline characteristics were not significantly different. Fifty-one infants were lost to follow-up (pre-AOC 6.9% (20/289), post-implementation 10.6% (31/292). The composite outcome of mortality or severe NDI was observed in 17.9% pre-AOC (41/229) vs. 24.0% (47/196) post-AOC (p = 0.12). No significant differences were found for the secondary outcomes such as mild-moderate NDI, Bayley-III composite scores, cerebral palsy GMFCS, and problem behaviour scores, with the exception of parent-reported readmissions until the moment of follow-up which was less frequent post-AOC than pre-AOC.Conclusion: In this cohort study, the implementation of automated oxygen control in our NICU as standard of care for preterm infants led to no statistically significant difference in neurodevelopmental outcome at 2 years of age.
引用
收藏
页码:1593 / 1599
页数:7
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