Automated oxygen control for very preterm infants and neurodevelopmental outcome at 2 years-a retrospective cohort study.
Eur J Pediatr
; 182(4): 1593-1599, 2023 Apr.
Article
in En
| MEDLINE
| ID: mdl-36693993
ABSTRACT
Faster resolution of hypoxaemic or hyperoxaemic events in preterm infants may reduce long-term neurodevelopmental impairment. Automatic titration of inspiratory oxygen increases time within the oxygen saturation target range and may provide a more prompt response to hypoxic and hyperoxic events. We assessed routinely performed follow-up at 2 years of age after the implementation of automated oxygen control (AOC) as standard care and compared this with a historical cohort. Neurodevelopmental outcomes at 2 years of age were compared for infants born at 24-29 weeks gestational age before (2012-2015) and after (2015-2018) the implementation of AOC as standard of care. The primary outcome was a composite outcome of either mortality or severe neurodevelopmental impairment (NDI), and other outcomes assessed were mild-moderate NDI, Bayley-III composite scores, cerebral palsy GMFCS, and CBCL problem behaviour scores. A total of 289 infants were included in the pre-AOC epoch and 292 in the post-AOC epoch. Baseline characteristics were not significantly different. Fifty-one infants were lost to follow-up (pre-AOC 6.9% (20/289), post-implementation 10.6% (31/292). The composite outcome of mortality or severe NDI was observed in 17.9% pre-AOC (41/229) vs. 24.0% (47/196) post-AOC (p = 0.12). No significant differences were found for the secondary outcomes such as mild-moderate NDI, Bayley-III composite scores, cerebral palsy GMFCS, and problem behaviour scores, with the exception of parent-reported readmissions until the moment of follow-up which was less frequent post-AOC than pre-AOC. CONCLUSION:
In this cohort study, the implementation of automated oxygen control in our NICU as standard of care for preterm infants led to no statistically significant difference in neurodevelopmental outcome at 2 years of age. WHAT IS KNOWN ⢠Neurodevelopmental outcome is linked to hypoxemia, hyperoxaemia and choice of SpO2 target range. ⢠Automated titration of inspired oxygen may provide a faster resolution of hypoxaemic and hyperoxaemic events. WHAT IS NEW ⢠This cohort study did not find a significant difference in neurodevelopmental outcome at two years of age after implementing automated oxygen control as standard of care.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cerebral Palsy
/
Neurodevelopmental Disorders
/
Infant, Premature, Diseases
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
/
Infant
/
Newborn
Language:
En
Journal:
Eur J Pediatr
Year:
2023
Document type:
Article
Affiliation country:
Netherlands