Mitra Souvik, Singh Balpreet, El-Naggar Walid, McMillan Douglas D
Division of Neonatal Perinatal Medicine, Department of Pediatrics, Dalhousie University & IWK Health Centre, Halifax, NS, Canada.
J Perinatol. 2018 Apr;38(4):351-360. doi: 10.1038/s41372-017-0037-z. Epub 2018 Jan 2.
To conduct a systematic review of clinical trials comparing automated versus manual fraction of inspired oxygen (FiO) control to target oxygen saturation (SpO) in preterm infants.
The authors searched MEDLINE, Embase, CENTRAL, and CINAHL from inception upto December 2016, reviewed conference proceedings and sought results of unpublished trials. Studies were included if automated FiO control was compared to manual control in preterm infants on positive pressure respiratory support. The primary outcome was percentage of time spent within the target SpO range. Summary mean differences (MD) were computed using random effects model.
Out of 276 identified studies 10 met the inclusion criteria. Automated FiO control significantly improved time being spent within the target SpO range [MD: 12.8%; 95% CI: 6.5-19.2%; I = 90%]. Periods of hyperoxia (MD:-8.8%; 95% CI: -15 to -2.7%), severe hypoxia(SpO < 80%)(MD: -0.9%;95%CI: -1.5 to -0.4%) and hypoxic events (MD: -5.6%; 95% CI: -9.1 to -2.1%) were significantly reduced with automated control.
Automated FiO adjustment provides significant improvement of time in target saturations, reduces periods of hyperoxia, and severe hypoxia in preterm infants on positive pressure respiratory support.
对比较自动与手动控制吸入氧分数（FiO）以达到早产儿目标血氧饱和度（SpO）的临床试验进行系统评价。
作者检索了自数据库建立至2016年12月的MEDLINE、Embase、CENTRAL和CINAHL数据库，查阅了会议论文集并寻找未发表试验的结果。纳入的研究需为比较在接受正压呼吸支持的早产儿中自动FiO控制与手动控制的研究。主要结局为在目标SpO范围内的时间百分比。使用随机效应模型计算汇总平均差（MD）。
在276项已识别研究中，10项符合纳入标准。自动FiO控制显著改善了在目标SpO范围内的时间[MD：12.8%；95%CI：6.5 - 19.2%；I² = 90%]。自动控制显著减少了高氧期（MD：-8.8%；95%CI：-15至-2.7%）、严重缺氧（SpO＜80%）（MD：-0.9%；95%CI：-1.5至-0.4%）和缺氧事件（MD：-5.6%；95%CI：-9.1至-2.1%）。
自动FiO调节显著改善了正压呼吸支持的早产儿在目标饱和度下的时间，减少了高氧期和严重缺氧情况。
