Automated oxygen control for very preterm infants and neurodevelopmental outcome at 2 years−a retrospective cohort study
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Published:2023-01-25
Issue:4
Volume:182
Page:1593-1599
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ISSN:1432-1076
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Container-title:European Journal of Pediatrics
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language:en
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Short-container-title:Eur J Pediatr
Author:
Salverda Hylke H.ORCID, Oldenburger N.Nathalie J., Rijken Monique, Tan R.Ratna N. G. B., Pas Arjan B. te, van Klink Jeanine M. M.
Abstract
AbstractFaster 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.
What is Known:• Neurodevelopmental outcome is linked to hypoxemia, hyperoxaemia and choice of SpO2 target range.• Automated titration of inspired oxygen may provide a faster resolution of hypoxaemic and hyperoxaemic events.
What is New: • This cohort study did not find a significant difference in neurodevelopmental outcome at two years of age after implementing automated oxygen control as standard of care.
Publisher
Springer Science and Business Media LLC
Subject
Pediatrics, Perinatology and Child Health
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