scholarly journals Closed loop automated oxygen control in neonates—A review

2019 ◽  
Vol 109 (5) ◽  
pp. 914-922 ◽  
Author(s):  
Sarah Sturrock ◽  
Emma Williams ◽  
Theodore Dassios ◽  
Anne Greenough
Keyword(s):  
Closed Loop ◽  
Oxygen Control ◽  
Automated Oxygen Control

Closed loop automated oxygen control in optimisation of mechanical ventilation in preterm infants

2020 ◽  
Author(s):  
Hemant Ambulkar ◽  
Sarah Sturrock ◽  
Samantha Sweeney ◽  
Nadja Bednarczuk ◽  
Emma Williams ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Preterm Infants ◽  
Closed Loop ◽  
Oxygen Control ◽  
Automated Oxygen Control

A randomised crossover trial of closed loop automated oxygen control in preterm, ventilated infants

2020 ◽  
Author(s):  
Sarah Sturrock ◽  
Hemant Ambulkar ◽  
Emma E. Williams ◽  
Samantha Sweeney ◽  
Nadja F. Bednarczuk ◽  
...  
Keyword(s):  
Closed Loop ◽  
Crossover Trial ◽  
Oxygen Control ◽  
Automated Oxygen Control

scholarly journals Survey of closed loop automated oxygen control systems in neonatal intensive care units

2021 ◽  
Author(s):  
Ourania Kaltsogianni ◽  
Theodore Dassios ◽  
Rayhan Belbal ◽  
Anne Greenough
Keyword(s):  
Intensive Care ◽  
Control Systems ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Closed Loop ◽  
Neonatal Intensive Care Units ◽  
Oxygen Control ◽  
Automated Oxygen Control

Automated control of oxygen titration in preterm infants on non-invasive respiratory support

2021 ◽  
pp. fetalneonatal-2020-321538
Author(s):  
Peter A Dargaville ◽  
Andrew P Marshall ◽  
Oliver J Ladlow ◽  
Charlotte Bannink ◽  
Rohan Jayakar ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Supplemental Oxygen ◽  
Respiratory Support ◽  
Target Range ◽  
Manual Control ◽  
Oxygen Control ◽  
Automated Control ◽  
Non Invasive ◽  
Automated Oxygen Control

ObjectiveTo evaluate the performance of a rapidly responsive adaptive algorithm (VDL1.1) for automated oxygen control in preterm infants with respiratory insufficiency.DesignInterventional cross-over study of a 24-hour period of automated oxygen control compared with aggregated data from two flanking periods of manual control (12 hours each).SettingNeonatal intensive care unit.ParticipantsPreterm infants receiving non-invasive respiratory support and supplemental oxygen; median birth gestation 27 weeks (IQR 26–28) and postnatal age 17 (12–23) days.InterventionAutomated oxygen titration with the VDL1.1 algorithm, with the incoming SpO2 signal derived from a standard oximetry probe, and the computed inspired oxygen concentration (FiO2) adjustments actuated by a motorised blender. The desired SpO2 range was 90%–94%, with bedside clinicians able to make corrective manual FiO2 adjustments at all times.Main outcome measuresTarget range (TR) time (SpO2 90%–94% or 90%–100% if in air), periods of SpO2 deviation, number of manual FiO2 adjustments and oxygen requirement were compared between automated and manual control periods.ResultsIn 60 cross-over studies in 35 infants, automated oxygen titration resulted in greater TR time (manual 58 (51–64)% vs automated 81 (72–85)%, p<0.001), less time at both extremes of oxygenation and considerably fewer prolonged hypoxaemic and hyperoxaemic episodes. The algorithm functioned effectively in every infant. Manual FiO2 adjustments were infrequent during automated control (0.11 adjustments/hour), and oxygen requirements were similar (manual 28 (25–32)% and automated 26 (24–32)%, p=0.13).ConclusionThe VDL1.1 algorithm was safe and effective in SpO2 targeting in preterm infants on non-invasive respiratory support.Trial registration numberACTRN12616000300471.

scholarly journals Designing a Remote Closed-Loop Automatic Oxygen Control in Preterm Infants

2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Mohammad Reza Moradi ◽  
Sharareh R. Niakan Kalhori ◽  
Marian Ghazi Saeedi ◽  
Mohammad Reza Zarkesh ◽  
Abbas Habibelahi ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Pulse Oximeter ◽  
Closed Loop ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Target Range ◽  
Preterm Neonates ◽  
Oxygen Control ◽  
Fraction Of Inspired Oxygen ◽  
To Receive

Background: Different automated systems have been developed to improve the maintenance of target range of arterial oxygen saturation (SPO2) in premature infants with respiratory distress. Objectives: This study aimed to develop a remote closed-loop automatic oxygen control (RCLAC) as an efficient monitoring device. Then the means of the fraction of inspired oxygen (FIO2) and SPO2 by routine manual control (RMC) and RCLAC were compared. Methods: A developmental-descriptive study was carried out in an Iranian hospital (Tehran, Iran; 2015 - 2017). Twenty-two preterm infants with gestational age 24 - 28 weeks entered the study. A database was prepared based on pulse oximeter parameters. A Wi-Fi module was implemented to receive data from a pulse oximeter and send inputs to the user’s mobile. Vibrate alarm was implemented for high or low FIO2. After receiving notifications associated with an increase or decrease of FIO2 levels and user’s confirmation; the alterations were applied on the ventilator. Results: The mean FIO2 in the RMC system was significantly higher than the RCLAC system (98.1 ± 2.67 vs 79.5 ± 16.03; P = 0.0001). According to the results, when the SPO2 reached close to target SPO2 range and consequently FIO2 changed (decreased or increased based on target SPO2), heart rate showed a regular beating with a decrease in the numbers. Conclusions: Remote closed-loop automatic oxygen control system as a simple device could prevent preterm neonates from sustained hypo-hyperoxemic and arrhythmia episodes. Moreover, by using RCLAC, there was no need for continuous monitoring that may reduce the workload of NICU medical staff. Collecting reliable data and recording information in digital forms were also other benefits. Further studies with larger sample size are strongly suggested.

Closed-Loop Automatic Oxygen Control (CLAC) in Preterm Infants: A Randomized Controlled Trial

PEDIATRICS ◽  
2014 ◽  
Vol 133 (2) ◽  
pp. e379-e385 ◽  
Author(s):  
A. Hallenberger ◽  
C. F. Poets ◽  
W. Horn ◽  
A. Seyfang ◽  
M. S. Urschitz ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Preterm Infants ◽  
Closed Loop ◽  
Controlled Trial ◽  
Oxygen Control ◽  
Randomized Controlled

scholarly journals Comparison of two devices for automated oxygen control in preterm infants: a randomised crossover trial

2021 ◽  
pp. fetalneonatal-2020-321387
Author(s):  
Hylke H Salverda ◽  
Sophie J E Cramer ◽  
Ruben S G M Witlox ◽  
Timothy J Gale ◽  
Peter A Dargaville ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Preterm Infants ◽  
Random Sequence ◽  
Supplemental Oxygen ◽  
Respiratory Support ◽  
Target Range ◽  
Oxygen Control ◽  
Significant Difference ◽  
The Cost ◽  
Automated Oxygen Control

ObjectiveTo compare the effect of two different automated oxygen control devices on target range (TR) time and occurrence of hypoxaemic and hyperoxaemic episodes.DesignRandomised cross-over study.SettingTertiary level neonatal unit in the Netherlands.PatientsPreterm infants (n=15) born between 24+0 and 29+6 days of gestation, receiving invasive or non-invasive respiratory support with oxygen saturation (SpO2) TR of 91%–95%. Median gestational age 26 weeks and 4 days (IQR 25 weeks 3 days–27 weeks 6 days) and postnatal age 19 (IQR 17–24) days.InterventionsInspired oxygen concentration was titrated by the OxyGenie controller (SLE6000 ventilator) and the CLiO2 controller (AVEA ventilator) for 24 hours each, in a random sequence, with the respiratory support mode kept constant.Main outcome measuresTime spent within set SpO2 TR (91%–95% with supplemental oxygen and 91%–100% without supplemental oxygen).ResultsTime spent within the SpO2 TR was higher during OxyGenie control (80.2 (72.6–82.4)% vs 68.5 (56.7–79.3)%, p<0.005). Less time was spent above TR while in supplemental oxygen (6.3 (5.1–9.9)% vs 15.9 (11.5–30.7)%, p<0.005) but more time spent below TR during OxyGenie control (14.7 (11.8%–17.2%) vs 9.3 (8.2–12.6)%, p<0.05). There was no significant difference in time with SpO2 <80% (0.5 (0.1–1.0)% vs 0.2 (0.1–0.4)%, p=0.061). Long-lasting SpO2 deviations occurred less frequently during OxyGenie control.ConclusionsThe OxyGenie control algorithm was more effective in keeping the oxygen saturation within TR and preventing hyperoxaemia and equally effective in preventing hypoxaemia (SpO2 <80%), although at the cost of a small increase in mild hypoxaemia.Trial registry numberNCT03877198

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