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More time in optimal SpO2 range with closed-loop FiO2 control

Artikel

More time in optimal SpO2 range with closed-loop FiO2 control

Datum: 08.11.2022

A recent study in pediatric patients showed they spent significantly more time in the optimal SpO2 range with closed-loop control of FiO2 than with manual FiO2 titration (1). The number of adjustments was also significantly higher and the oxygen usage lower with closed-loop FiO2 control.
Screenshot front page of study
Screenshot front page of study

This randomized crossover trial included 30 patients with an average age of 21 months and heterogenous lung conditions. The investigators at the Dr Behcet Uz Children's Disease and Surgery Training and Research Hospital in Izmir, Turkey, ventilated them with standard Adaptive Support Ventilation® settings for two phases. During one, the INTELLiVENT-ASV FiO2 controller was activated and during the other, FiO2 was titrated manually. Minute ventilation and PEEP were maintained at the same level during the two phases.

Key findings

Compared with manual FiO2 titration, activation of the FiO2 controller resulted in:

  • Significantly more time spent in the optimal SpO2 range (96.1% vs 78.4%; p < 0.001)
  • Significantly less time spent in unacceptably low, suboptimally low, acceptably low, and suboptimally high SpO2 ranges
  • A far greater total number of adjustments (total number per patient 52 vs 1)
  • A lower median oxygenation index and lower median O2 usage 

These findings indicate the potential for greater efficiency with closed-loop FiO2 control - not only in terms of oxygen requirements, but also in terms of the number of adjustments possible without increasing the staff's workload.

See full citation below: (Soydan E, Ceylan G, Topal S, et al. Automated closed-loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients-A randomized crossover clinical trial. Front Med (Lausanne). 2022;9:969218. Published 2022 Aug 25. doi:10.3389/fmed.2022.9692181​)

Automated closed-loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients-A randomized crossover clinical trial.

Authors: Ekin Soydan, Gokhan Ceylan, Sevgi Topal, Pinar Hepduman, Gulhan Atakul, Mustafa Colak, Ozlem Sandal, Ferhat Sari, Utku Karaarslan, Dominik Novotni, Marcus J Schultz, Hasan Agin