Hylke Salverda

Abstract Objective To compare the effect of two different automated oxygen control devices in preterm infants on time spent in different oxygen saturation (SpO2) ranges during their entire stay in the NICU. Design Retrospective cohort study of prospectively collected data. Setting Tertiary level neonatal unit in the Netherlands. Patients Preterm infants (OxyGenie 75 infants, CLiO2 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 CLiO2 controller (AVEA ventilator) between October 2015 and December 2018 as standard of care. Main outcome measures Time spent within SpO2 target range (TR, 91-95% for either epoch) and other SpO2 ranges. Results Time spent within the SpO2 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 (SpO2<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 FiO2 (29.5 [28.0 – 33.2]% vs 29.6 [27.7-32.1]%, p=non significant) Conclusions Oxygen saturation targeting was better in the OxyGenie epoch in preterm infants, with less time in hypoxic and hyperoxic SpO2 ranges during their stay in NICU. Keywords: Hypoxemia; hyperoxia; closed-loop; algorithm; neonate