Automated closed–loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients–A randomized crossover clinical trial
IntroductionWe aimed to compare automated ventilation with closed–loop control of the fraction of inspired oxygen (FiO2) to automated ventilation with manual titrations of the FiO2 with respect to time spent in predefined pulse oximetry (SpO2) zones in pediatric critically ill patients.MethodsThis w...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.969218/full |
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| author | Ekin Soydan Gokhan Ceylan Gokhan Ceylan Sevgi Topal Pinar Hepduman Gulhan Atakul Mustafa Colak Ozlem Sandal Ferhat Sari Utku Karaarslan Dominik Novotni Marcus J. Schultz Marcus J. Schultz Hasan Agin |
| author_facet | Ekin Soydan Gokhan Ceylan Gokhan Ceylan Sevgi Topal Pinar Hepduman Gulhan Atakul Mustafa Colak Ozlem Sandal Ferhat Sari Utku Karaarslan Dominik Novotni Marcus J. Schultz Marcus J. Schultz Hasan Agin |
| author_sort | Ekin Soydan |
| collection | DOAJ |
| description | IntroductionWe aimed to compare automated ventilation with closed–loop control of the fraction of inspired oxygen (FiO2) to automated ventilation with manual titrations of the FiO2 with respect to time spent in predefined pulse oximetry (SpO2) zones in pediatric critically ill patients.MethodsThis was a randomized crossover clinical trial comparing Adaptive Support Ventilation (ASV) 1.1 with use of a closed–loop FiO2 system vs. ASV 1.1 with manual FiO2 titrations. The primary endpoint was the percentage of time spent in optimal SpO2 zones. Secondary endpoints included the percentage of time spent in acceptable, suboptimal and unacceptable SpO2 zones, and the total number of FiO2 changes per patient.ResultsWe included 30 children with a median age of 21 (11–48) months; 12 (40%) children had pediatric ARDS. The percentage of time spent in optimal SpO2 zones increased with use of the closed–loop FiO2 controller vs. manual oxygen control [96.1 (93.7–98.6) vs. 78.4 (51.3–94.8); P < 0.001]. The percentage of time spent in acceptable, suboptimal and unacceptable zones decreased. Findings were similar with the use of closed-loop FiO2 controller compared to manual titration in patients with ARDS [95.9 (81.6–98.8) vs. 78 (49.5–94.8) %; P = 0.027]. The total number of closed-loop FiO2 changes per patient was 52 (11.8–67), vs. the number of manual changes 1 (0–2), (P < 0.001).ConclusionIn this randomized crossover trial in pediatric critically ill patients under invasive ventilation with ASV, use of a closed–loop control of FiO2 titration increased the percentage of time spent within in optimal SpO2 zones, and increased the total number of FiO2 changes per patient.Clinical trial registrationClinicalTrials.gov, identifier: NCT04568642. |
| first_indexed | 2024-04-14T02:50:19Z |
| format | Article |
| id | doaj.art-89361778e965413c91ab0a623e487aae |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-14T02:50:19Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-89361778e965413c91ab0a623e487aae2022-12-22T02:16:18ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-08-01910.3389/fmed.2022.969218969218Automated closed–loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients–A randomized crossover clinical trialEkin Soydan0Gokhan Ceylan1Gokhan Ceylan2Sevgi Topal3Pinar Hepduman4Gulhan Atakul5Mustafa Colak6Ozlem Sandal7Ferhat Sari8Utku Karaarslan9Dominik Novotni10Marcus J. Schultz11Marcus J. Schultz12Hasan Agin13Department of Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, TurkeyDepartment of Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, TurkeyDepartment of Medical Research, Hamilton Medical AG, Bonaduz, SwitzerlandDepartment of Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, TurkeyDepartment of Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, TurkeyDepartment of Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, TurkeyDepartment of Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, TurkeyDepartment of Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, TurkeyDepartment of Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, TurkeyDepartment of Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, TurkeyDepartment of Medical Research, Hamilton Medical AG, Bonaduz, SwitzerlandDepartment of Medical Research, Hamilton Medical AG, Bonaduz, SwitzerlandDepartment of Intensive Care, Amsterdam UMC, Location “Academic Medical Center”, Amsterdam, NetherlandsDepartment of Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Disease and Surgery Training and Research Hospital, Health Sciences University, Izmir, TurkeyIntroductionWe aimed to compare automated ventilation with closed–loop control of the fraction of inspired oxygen (FiO2) to automated ventilation with manual titrations of the FiO2 with respect to time spent in predefined pulse oximetry (SpO2) zones in pediatric critically ill patients.MethodsThis was a randomized crossover clinical trial comparing Adaptive Support Ventilation (ASV) 1.1 with use of a closed–loop FiO2 system vs. ASV 1.1 with manual FiO2 titrations. The primary endpoint was the percentage of time spent in optimal SpO2 zones. Secondary endpoints included the percentage of time spent in acceptable, suboptimal and unacceptable SpO2 zones, and the total number of FiO2 changes per patient.ResultsWe included 30 children with a median age of 21 (11–48) months; 12 (40%) children had pediatric ARDS. The percentage of time spent in optimal SpO2 zones increased with use of the closed–loop FiO2 controller vs. manual oxygen control [96.1 (93.7–98.6) vs. 78.4 (51.3–94.8); P < 0.001]. The percentage of time spent in acceptable, suboptimal and unacceptable zones decreased. Findings were similar with the use of closed-loop FiO2 controller compared to manual titration in patients with ARDS [95.9 (81.6–98.8) vs. 78 (49.5–94.8) %; P = 0.027]. The total number of closed-loop FiO2 changes per patient was 52 (11.8–67), vs. the number of manual changes 1 (0–2), (P < 0.001).ConclusionIn this randomized crossover trial in pediatric critically ill patients under invasive ventilation with ASV, use of a closed–loop control of FiO2 titration increased the percentage of time spent within in optimal SpO2 zones, and increased the total number of FiO2 changes per patient.Clinical trial registrationClinicalTrials.gov, identifier: NCT04568642.https://www.frontiersin.org/articles/10.3389/fmed.2022.969218/fullintensive carepediatric intensive caremechanical ventilationAdaptive support ventilationASVclosed loop ventilation |
| spellingShingle | Ekin Soydan Gokhan Ceylan Gokhan Ceylan Sevgi Topal Pinar Hepduman Gulhan Atakul Mustafa Colak Ozlem Sandal Ferhat Sari Utku Karaarslan Dominik Novotni Marcus J. Schultz Marcus J. Schultz Hasan Agin Automated closed–loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients–A randomized crossover clinical trial Frontiers in Medicine intensive care pediatric intensive care mechanical ventilation Adaptive support ventilation ASV closed loop ventilation |
| title | Automated closed–loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients–A randomized crossover clinical trial |
| title_full | Automated closed–loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients–A randomized crossover clinical trial |
| title_fullStr | Automated closed–loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients–A randomized crossover clinical trial |
| title_full_unstemmed | Automated closed–loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients–A randomized crossover clinical trial |
| title_short | Automated closed–loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients–A randomized crossover clinical trial |
| title_sort | automated closed loop fio2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients a randomized crossover clinical trial |
| topic | intensive care pediatric intensive care mechanical ventilation Adaptive support ventilation ASV closed loop ventilation |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.969218/full |
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