Comparison of two automated oxygen controllers in oxygen targeting in preterm infants during admission: an observational study.

Objective: To compare the effect of two different automated oxygen control devices on time preterm infants spent in different oxygen saturation (SpO) ranges during their entire stay in the neonatal intensive care unit (NICU).

Design: Retrospective cohort study of prospectively collected data.

Setting: Tertiary level neonatal unit in the Netherlands.

Patients: Preterm infants (OxyGenie 75 infants, CLiO 111 infants) born at 24-29 weeks' gestation receiving at least 72 hours of respiratory support between October 2015 and November 2020.

Interventions: Inspired oxygen concentration was titrated by the OxyGenie controller (SLE6000 ventilator) between February 2019 and November 2020 and the CLiO controller (AVEA ventilator) between October 2015 and December 2018 as standard of care.

Main Outcome Measures: Time spent within SpO target range (TR, 91-95% for either epoch) and other SpO ranges.

Results: Time spent within the SpO TR when receiving supplemental oxygen was higher during OxyGenie control (median 71.5 [IQR 64.6-77.0]% vs 51.3 [47.3-58.5]%, p<0.001). Infants under OxyGenie control spent less time in hypoxic and hyperoxic ranges (SpO<80%: 0.7 [0.4-1.4]% vs 1.2 [0.7-2.3]%, p<0.001; SpO2>98%: 1.0 [0.5-2.4]% vs 4.0 [2.0-7.9]%, p<0.001). Both groups received a similar FiO (29.5 [28.0-33.2]% vs 29.6 [27.7-32.1]%, p=not significant).

Conclusions: Oxygen saturation targeting was significantly different in the OxyGenie epoch in preterm infants, with less time in hypoxic and hyperoxic SpO ranges during their stay in the NICU.