Quicker response results in better SpO2 control – a comparison of 3 FiO2-titration strategies in ventilated preterm infants
Journal Title: Annals of Agricultural and Environmental Medicine - Year 2015, Vol 22, Issue 4
Abstract
[b][/b][b]Introduction.[/b] The impact of SpO2 target ranges (TR) has been carefully studied; however, reports suggest a wide variation among infants and centres in maintaining the intended range. Little is known about the effectiveness of different approaches to manual control. Auto-SpO2 controllers are now available which show promise. [b]Objective. [/b]The aim was to compare two different protocol-driven manual strategies with different response requirements to each other, and a faster automated system (AveaCLiO2, Yorba Linda, CA, USA). [b]Materials and methods.[/b] In a crossover design, each of the three FiO2/SpO2 approaches was implemented in three randomly assigned consecutive 2.5-hour runs. The two manual strategies (Attentive and Observational) were implemented by a trained operator. The primary endpoints were time in 1) SpO2 TR, 2) < 80% SpO2 and 3) >98% SpO2. [b]Results. [/b]Fifteen studies were completed. All three approaches resulted in good control, with time in the target range >60%. CLiO2 use reflected reduced exposure at the two SpO2 extremes. Post hoc analysis determined that the differences were more marked in the infants with more frequent desaturations. Likewise, in this group, the Attentive strategy performed better than the Observative. [b]Conclusions.[/b] All three approaches provided excellent control of SpO2 in infants with infrequent desaturations, significantly better than typical routine care. In hard to manage infants with frequent desaturations, faster response appeared to result in better control. The potential of automating the tedious error prone FiO2 adjustment offers significant promise. If manual titration of FiO2 is to remain the usual method of care, additional studies are needed to identify optimal approaches.
Authors and Affiliations
Maria Wilińska, Thomas Bachman, Janusz Swietlinski, Anna Wasko, Gregory Jakiel
Keywords
Related Articles
- EP ID EP81040
- DOI -
- Views 161
- Downloads 0
Prevalence of metabolic syndrome among 40- and 50-year-old inhabitants of Wroclaw, Poland
Introduction and objective. The metabolic syndrome (MetS) has been discussed for many years, but there is no doubt that those who have confirmed the presence of risk factors comprising the MetS had a higher risk of cardi...
Air-spore in Cartagena, Spain: Viable and non-viable sampling methods
In the presented study the airborne fungal spores of the semiarid city of Cartagena, Spain, are identified and quantified by means of viable or non-viable sampling methods. Airborne fungal samples were collected simultan...
Can selection explain the protective effects of farming on asthma?
[i][/i]Introduction and objective. Reduced asthma and allergy risks in farmers have been ascribed to microbial exposures. However, selection may also play a role and this was assessed in two Scandinavian farming populati...
Universal screening as a recommendation for thyroid tests in pregnant women
According to recent recommendations, thyroid tests in pregnancy should be performed only in women in risk groups. However, detailed studies indicate that such an approach results in missing hypothyroidism in 30% and hype...
Virulence and antibiotic resistance of Escherichia coli isolated from rooks
With regard to antibiotic resistance studies in various model animals in the urban environment, the presented study focused on the rook, many behavioural and ecological aspects of which are important from an epidemiologi...