PDF(Pubmed)
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.
CONCLUSIONS: 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.
BACKGROUND: • 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.
BACKGROUND: • 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.
CONCLUSIONS: 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.
BACKGROUND: • 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.
BACKGROUND: • 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.
摘要：
早产儿低氧血症或高氧血症事件的更快解决可能会减少长期神经发育障碍。吸入氧气的自动滴定增加了在氧饱和度目标范围内的时间,并且可以提供对缺氧和高氧事件的更迅速的响应。我们评估了实施自动氧气控制（AOC）作为标准护理后2岁时的常规随访，并将其与历史队列进行了比较。比较了在实施AOC作为护理标准之前（2012-2015年）和之后（2015-2018年）出生在24-29周胎龄的婴儿在2岁时的神经发育结果。主要结局是死亡率或严重神经发育障碍（NDI）的复合结局。其他评估结果为轻度-中度NDI，Bayley-III综合得分,脑瘫GMFCS，和CBCL问题行为得分。AOC前时代共有289名婴儿，AOC后时代共有292名婴儿。基线特征没有显著差异。51名婴儿失去随访（AOC前6.9％（20/289），实施后10.6%（31/292）。在17.9%前AOC（41/229）与17.9%观察到死亡率或严重NDI的复合结局。AOC后24.0%（47/196）（p=0.12）。次要结局没有发现显著差异，如轻-中度NDI，Bayley-III综合得分,脑瘫GMFCS，和问题行为得分，除了家长报告的再入院，直到随访时刻，AOC后的频率低于AOC前。
结论：在这项队列研究中，在我们的NICU中实施自动氧控制作为早产儿护理标准,导致2岁时神经发育结局无统计学差异.
背景：•神经发育结果与低氧血症有关，高氧血症和SpO2目标范围的选择。•吸入氧的自动滴定可以提供低氧血症和高氧血症事件的更快解决。
背景：•这项队列研究在实施自动氧气控制作为护理标准后，在两岁时的神经发育结局没有发现显着差异。
结论：在这项队列研究中，在我们的NICU中实施自动氧控制作为早产儿护理标准,导致2岁时神经发育结局无统计学差异.
背景：•神经发育结果与低氧血症有关，高氧血症和SpO2目标范围的选择。•吸入氧的自动滴定可以提供低氧血症和高氧血症事件的更快解决。
背景：•这项队列研究在实施自动氧气控制作为护理标准后，在两岁时的神经发育结局没有发现显着差异。
