Hylke Salverda

Abstract Objective To compare short-termclinical outcome after using two different automated oxygen controllers (OxyGenie and CLiO2) Design Propensity score matched retrospective observational study Setting Tertiary level neonatal unit in the Netherlands Patients Preterm infants (OxyGenie n=121, CLiO2 n=121) born between 24+0-29+6 weeks of gestation. Median [IQR] gestational age in the OxyGenie cohort was 28+3 [26+3.5–29+0] versus 27+5 [26+5–28+3] in the CLiO2 cohort, respectively 42% and 46% of infants were male and mean (SD) birth weight was 1034 (266) grams vs 1022 (242) grams. Interventions Inspired oxygen was titrated by OxyGenie (SLE6000) or CLiO2 (AVEA) during respiratory support. Main outcome measures Mortality, retinopathy of prematurity, bronchopulmonary dysplasia, and necrotising enterocolitis. Results Fewer infants in the OxyGenie group received laser coagulation for ROP (1 infant vs 10; risk ratio 0.1 (95%-CI 0.0 – 0.7); p=0.008), and infants stayed shorter in the NICU (28 [15-42] vs 40 [25-61] days; median difference 13.5 days (95%-CI 8.5 – 19.5); p<0.001). Infants in the OxyGenie group had fewer days on continuous positive airway pressure (8.4 [4.8-19.8] days vs. 16.7 [6.3-31.1]; p<0.001) and significantly shorter number of days on invasive ventilation (0 [0-4.2] days vs. 2.1 [0-8.4]; p=0.012). There were no statistically significant differences in all other morbidities. Conclusions In this propensity score matched retrospective study, the OxyGenie epoch was associated with less morbidity when compared to the CLiO2 epoch. There were significantly fewer infants that received treatment for ROP, received less intensive respiratory support and, although there were more supplemental oxygen days, the duration of stay in the NICU was shorter. A larger study will have to replicate these findings. Keywords Hypoxemia; hyperoxia; closed-loop; algorithm; neonate; respiratory