Outcomes after automated oxygen control for preterm infants

Salverda, H.H. (2022)

Doctoral Thesis

Most preterm infants need respiratory support and extra oxygen during their admission to the neonatal intensive care. The amount of oxygen required can fluctuate a lot. Bedside staff frequently administer extra oxygen, and when the blood oxygen level is normalised, reduce this extra oxygen carefully. This is a delicate process, a fraction too much or a fraction too little may harm their underdeveloped organs.
As one of the first, the LUMC has been titrating oxygen automatically since 2015. In this thesis we investigated the effect of this automatization and how preterm infants can profit from this technology. We found that automated oxygen titration reduced the duration of invasive ventilation, but outcome at two years of age was left unchanged. A new automated oxygen controller from 2018 led to even more improvement. Infants spent more time in the narrow therapeutic range, needed even less intensive respiratory support and developed less retinopathy – a disease of the retina which, when untreated, can lead to blindness.
From this thesis we can conclude that there is a short-term benefit from automated oxygen titration and we are moving in the right direction. Further research is needed to make the most out of this technology.

• Neonatology
• Hypoxia
• Hyperoxia
• Closed-loop
• Ventilation
• Respiratory

• All authors: Salverda, H.H.
• Supervisor: Pas, A.B. te; Dargaville, P.A.
• Committee: Lopriore, E.; Poets, C.F.; Jonge, E. de; Schalij-Delfos, N.E.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2022-11-03
• ISBN (print): 9789464585001
• ISBN (electronic): 9789464585018
• Sponsorship: SLE Limited Universitaire Bibliotheken Leiden Department of Paediatrics of the Leiden University Medical Center