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Closed–loop oxygen control improves oxygenation in pediatric patients under high–flow nasal oxygen—A randomized crossover study
BACKGROUND: We assessed the effect of a closed–loop oxygen control system in pediatric patients receiving high–flow nasal oxygen therapy (HFNO). METHODS: A multicentre, single–blinded, randomized, and cross–over study. Patients aged between 1 month and 18 years of age receiving HFNO for acute hypoxe...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708705/ https://www.ncbi.nlm.nih.gov/pubmed/36465920 http://dx.doi.org/10.3389/fmed.2022.1046902 |
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author | Sandal, Ozlem Ceylan, Gokhan Topal, Sevgi Hepduman, Pinar Colak, Mustafa Novotni, Dominik Soydan, Ekin Karaarslan, Utku Atakul, Gulhan Schultz, Marcus J. Ağın, Hasan |
author_facet | Sandal, Ozlem Ceylan, Gokhan Topal, Sevgi Hepduman, Pinar Colak, Mustafa Novotni, Dominik Soydan, Ekin Karaarslan, Utku Atakul, Gulhan Schultz, Marcus J. Ağın, Hasan |
author_sort | Sandal, Ozlem |
collection | PubMed |
description | BACKGROUND: We assessed the effect of a closed–loop oxygen control system in pediatric patients receiving high–flow nasal oxygen therapy (HFNO). METHODS: A multicentre, single–blinded, randomized, and cross–over study. Patients aged between 1 month and 18 years of age receiving HFNO for acute hypoxemic respiratory failure (AHRF) were randomly assigned to start with a 2–h period of closed–loop oxygen control or a 2–h period of manual oxygen titrations, after which the patient switched to the alternative therapy. The endpoints were the percentage of time spent in predefined SpO(2) ranges (primary), FiO(2), SpO(2)/FiO(2), and the number of manual adjustments. FINDINGS: We included 23 patients, aged a median of 18 (3–26) months. Patients spent more time in a predefined optimal SpO(2) range when the closed–loop oxygen controller was activated compared to manual oxygen titrations [91⋅3% (IQR 78⋅4–95⋅1%) vs. 63⋅0% (IQR 44⋅4–70⋅7%)], mean difference [28⋅2% (95%–CI 20⋅6–37⋅8%); P < 0.001]. Median FiO(2) was lower [33⋅3% (IQR 26⋅6–44⋅6%) vs. 42⋅6% (IQR 33⋅6–49⋅9%); P = 0.07], but median SpO(2)/FiO(2) was higher [289 (IQR 207–348) vs. 194 (IQR 98–317); P = 0.023] with closed–loop oxygen control. The median number of manual adjustments was lower with closed–loop oxygen control [0⋅0 (IQR 0⋅0–0⋅0) vs. 0⋅5 (IQR 0⋅0–1⋅0); P < 0.001]. CONCLUSION: Closed-loop oxygen control improves oxygenation therapy in pediatric patients receiving HFNO for AHRF and potentially leads to more efficient oxygen use. It reduces the number of manual adjustments, which may translate into decreased workloads of healthcare providers. CLINICAL TRIAL REGISTRATION: [www.ClinicalTrials.gov], identifier [NCT 05032365]. |
format | Online Article Text |
id | pubmed-9708705 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97087052022-12-01 Closed–loop oxygen control improves oxygenation in pediatric patients under high–flow nasal oxygen—A randomized crossover study Sandal, Ozlem Ceylan, Gokhan Topal, Sevgi Hepduman, Pinar Colak, Mustafa Novotni, Dominik Soydan, Ekin Karaarslan, Utku Atakul, Gulhan Schultz, Marcus J. Ağın, Hasan Front Med (Lausanne) Medicine BACKGROUND: We assessed the effect of a closed–loop oxygen control system in pediatric patients receiving high–flow nasal oxygen therapy (HFNO). METHODS: A multicentre, single–blinded, randomized, and cross–over study. Patients aged between 1 month and 18 years of age receiving HFNO for acute hypoxemic respiratory failure (AHRF) were randomly assigned to start with a 2–h period of closed–loop oxygen control or a 2–h period of manual oxygen titrations, after which the patient switched to the alternative therapy. The endpoints were the percentage of time spent in predefined SpO(2) ranges (primary), FiO(2), SpO(2)/FiO(2), and the number of manual adjustments. FINDINGS: We included 23 patients, aged a median of 18 (3–26) months. Patients spent more time in a predefined optimal SpO(2) range when the closed–loop oxygen controller was activated compared to manual oxygen titrations [91⋅3% (IQR 78⋅4–95⋅1%) vs. 63⋅0% (IQR 44⋅4–70⋅7%)], mean difference [28⋅2% (95%–CI 20⋅6–37⋅8%); P < 0.001]. Median FiO(2) was lower [33⋅3% (IQR 26⋅6–44⋅6%) vs. 42⋅6% (IQR 33⋅6–49⋅9%); P = 0.07], but median SpO(2)/FiO(2) was higher [289 (IQR 207–348) vs. 194 (IQR 98–317); P = 0.023] with closed–loop oxygen control. The median number of manual adjustments was lower with closed–loop oxygen control [0⋅0 (IQR 0⋅0–0⋅0) vs. 0⋅5 (IQR 0⋅0–1⋅0); P < 0.001]. CONCLUSION: Closed-loop oxygen control improves oxygenation therapy in pediatric patients receiving HFNO for AHRF and potentially leads to more efficient oxygen use. It reduces the number of manual adjustments, which may translate into decreased workloads of healthcare providers. CLINICAL TRIAL REGISTRATION: [www.ClinicalTrials.gov], identifier [NCT 05032365]. Frontiers Media S.A. 2022-11-16 /pmc/articles/PMC9708705/ /pubmed/36465920 http://dx.doi.org/10.3389/fmed.2022.1046902 Text en Copyright © 2022 Sandal, Ceylan, Topal, Hepduman, Colak, Novotni, Soydan, Karaarslan, Atakul, Schultz and Ağın. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Sandal, Ozlem Ceylan, Gokhan Topal, Sevgi Hepduman, Pinar Colak, Mustafa Novotni, Dominik Soydan, Ekin Karaarslan, Utku Atakul, Gulhan Schultz, Marcus J. Ağın, Hasan Closed–loop oxygen control improves oxygenation in pediatric patients under high–flow nasal oxygen—A randomized crossover study |
title | Closed–loop oxygen control improves oxygenation in pediatric patients under high–flow nasal oxygen—A randomized crossover study |
title_full | Closed–loop oxygen control improves oxygenation in pediatric patients under high–flow nasal oxygen—A randomized crossover study |
title_fullStr | Closed–loop oxygen control improves oxygenation in pediatric patients under high–flow nasal oxygen—A randomized crossover study |
title_full_unstemmed | Closed–loop oxygen control improves oxygenation in pediatric patients under high–flow nasal oxygen—A randomized crossover study |
title_short | Closed–loop oxygen control improves oxygenation in pediatric patients under high–flow nasal oxygen—A randomized crossover study |
title_sort | closed–loop oxygen control improves oxygenation in pediatric patients under high–flow nasal oxygen—a randomized crossover study |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708705/ https://www.ncbi.nlm.nih.gov/pubmed/36465920 http://dx.doi.org/10.3389/fmed.2022.1046902 |
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