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早产儿有创通气中闭环自动氧控的随机交叉试验

A randomised crossover trial of closed loop automated oxygen control in preterm, ventilated infants.

机构信息

Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Neonatal Intensive Care Centre, King's College Hospital, London, UK.

出版信息

Acta Paediatr. 2021 Mar;110(3):833-837. doi: 10.1111/apa.15585. Epub 2020 Oct 6.

Abstract

AIM

To determine whether closed loop automated oxygen control resulted in a reduction in the duration and severity of desaturation episodes and the number of blood gases and chest radiographs in preterm, ventilated infants.

METHODS

Infants were studied on two consecutive days for 12 hours on each day. They were randomised to receive standard care (standard period) or standard care with a closed loop automated oxygen control system (automated oxygen control period) first.

RESULTS

Twenty-four infants with a median gestational age of 25.7 (range 23.1-32.6) weeks were studied at a median postconceptional age of 27.4 (range 24.3-34.9) weeks. During the automated oxygen control period, there were fewer desaturations that lasted >30 seconds (P = .032) or >60 seconds (P = .002), infants spent a higher proportion of the time within their target SpO range during the automated oxygen control period (P < .001), and fewer manual adjustments were made to the inspired oxygen concentration (mean 0.58 vs mean 11.29) (P < .001). There were no significant differences in the number of blood gases (P = .872) or chest radiographs (P = .366) between the two periods.

CONCLUSION

Closed loop automated oxygen delivery resulted in fewer prolonged desaturations with more time spent in the targeted oxygen range.

摘要

目的

确定闭环自动氧控是否能减少早产儿机械通气时的低氧血症持续时间和严重程度、血气分析和胸部 X 光片的数量。

方法

连续两天,每天 12 小时,将患儿随机分为标准治疗组(标准组)或标准治疗加闭环自动氧控组(自动氧控组)。

结果

24 例患儿的中位胎龄为 25.7 周(范围 23.1-32.6 周),校正胎龄为 27.4 周(范围 24.3-34.9 周)。在自动氧控组,持续时间超过 30 秒(P=0.032)或超过 60 秒(P=0.002)的低氧血症发作更少,患儿在自动氧控组中 SpO2 目标范围内的时间比例更高(P<0.001),需要调整吸入氧浓度的次数更少(均值 0.58 比 11.29)(P<0.001)。两组血气分析(P=0.872)或胸部 X 光片(P=0.366)的数量无显著差异。

结论

闭环自动氧输送可减少长时间低氧血症的发生,使更多时间处于目标氧范围。

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