期刊名称：Annals of Agricultural and Environmental Medicine
印刷版ISSN：1232-1966
电子版ISSN：1898-2263
出版年度：2015
卷号：22
期号：4
页码：708-712
DOI：10.5604/12321966.1185781
出版社：Institute of Agricultural Medicine in Lublin
摘要：Introduction. The impact of SpO2 target ranges (TR) has been carefully studied; however, reports suggest a wide variationamong infants and centres in maintaining the intended range. Little is known about the effectiveness of different approachesto manual control. Auto-SpO2 controllers are now available which show promise.Objective. The aim was to compare two different protocol-driven manual strategies with different response requirementsto each other, and a faster automated system (AveaCLiO2, Yorba Linda, CA, USA).Materials and methods. In a crossover design, each of the three FiO2/SpO2 approaches was implemented in three randomlyassigned consecutive 2.5-hour runs. The two manual strategies (Attentive and Observational) were implemented by atrained operator. The primary endpoints were time in 1) SpO2 TR, 2) < 80% SpO2 and 3) >98% SpO2.Results. 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 weremore marked in the infants with more frequent desaturations. Likewise, in this group, the Attentive strategy performedbetter than the Observative.Conclusions. All three approaches provided excellent control of SpO2 in infants with infrequent desaturations, significantlybetter than typical routine care. In hard to manage infants with frequent desaturations, faster response appeared to resultin better control. The potential of automating the tedious error prone FiO2 adjustment offers significant promise. If manualtitration of FiO2 is to remain the usual method of care, additional studies are needed to identify optimal approaches
