Elsevier

The Journal of Pediatrics

Volume 131, Issue 5, November 1997, Pages 754-756
The Journal of Pediatrics

Computer-assisted adjustment of inspired oxygen concentration improves control of oxygen saturation in newborn infants requiring mechanical ventilation,☆☆

https://doi.org/10.1016/S0022-3476(97)70107-0Get rights and content

Abstract

Open-loop computer control of inspired oxygen concentration was evaluated in 16 newborn infants requiring mechanical ventilation. F io2 and oxygen saturation were compared for 2-hour periods of computer versus routine manual F io2 adjustment. During computer-assisted F io2 adjustment, patients spent more time at the target Sa o2 and less time with Sa o2 < 90%. (J Pediatr 1997;131:754-6)

Section snippets

Methods

The clinical trial was implemented in two neonatal intensive care units after institutional review board approval. Informed consent was obtained from the parents of all enrolled patients. Patients were eligible if they required supplemental oxygen and mechanical ventilation. Patients were excluded if they had significant pulmonary hypertension or if they required vasoactive medications to maintain blood pressure.

A target Sa o2 was selected for each subject by the primary care team. The trial

Results

Characteristics of the 16 patients enrolled in the study are summarized in the Table.

Table. Patient characteristics

Patient No.GA (wk)BW (gm)Age at study (d)DiagnosisSa o2 (%)F io2 (%)
1321510101TEF/esophageal atresia9324
228107020Pneumothorax9364
33014605RDS9321
42870024TEF/esophageal atresia, sepsis9329
53224008Omphalocele, ASD, aortic coarctation9543
627126519Cystic adenomatoid malfor- mation of left lung9327
741400014Camptomelic dysplasia9323
82777016RDS9528
93012405RDS9331
1026103020RDS9253
112578013RDS

Discussion

We tested a newly designed computer-assisted F io2 control system in newborn infants requiring mechanical ventilation. To our knowledge, our study is the first controlled trial that shows significantly improved control of Sa o2 when using computerized F io2 adjustment compared with routine manual care. Morozoff and Evans 3 tested a computerized F io2 controller in newborn infants requiring mechanical ventilation but did not show improved control of Sa o2 . Bhutani et al. 4 tested an automated F

Acknowledgements

We thank Dr. Eric Eichenwald and Professor Peter Szolovits for their critical review of this manuscript and Dr. Friedrich Steinman for his initial encouragement to investigate fuzzy logic control. We also thank the nursing and medical staff of Children’s Hospital and Brigham and Women’s Hospital neonatal intensive care units.

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There are more references available in the full text version of this article.

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Reprint requests: Yao Sun, MD, CWN-418, Brigham & Women’s Hospital, 75 Francis Street, Boston, MA 02115.

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0022-3476/97/$5.00 + 0 9/22/80248

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