Environmental or Nasal Cannula Supplemental Oxygen for Preterm Infants: A Randomized Cross-Over Trial - 23/08/18
, Waldemar A. Carlo, MD 1, Arie Nakhmani, PhD 2, Shweta Bhatia, BS 3, Samuel J. Gentle, MD 1, VenkataNagaSai Apurupa Amperayani, BTEEE 4, Premananda Indic, PhD 4, Inmaculada Aban, PhD 5, Namasivayam Ambalavanan, MD 1Abstract |
Objective |
To test the hypothesis that environmental compared with nasal cannula oxygen decreases episodes of intermittent hypoxemia (oxygen saturations <85% for ≥10 seconds) in preterm infants on supplemental oxygen by providing a more stable hypopharyngeal oxygen concentration.
Study design |
This was a single center randomized crossover trial with a 1:1 parallel allocation to order of testing. Preterm infants on supplemental oxygen via oxygen environment maintained by a servo-controlled system or nasal cannula with flow rates ≤1.0 L per kg per minute were crossed over every 24 hours for 96 hours. Data were collected electronically to capture real time numeric and waveform data from patient monitors.
Results |
Twenty-five infants with gestational age of 27 ± 2 weeks (mean ± SD) and a birth weight of 933 ± 328 g were studied at postnatal day 36 ± 26. The number of episodes of intermittent hypoxemia per 24 hours was 117 ± 77 (median, 98; range, 4-335) with oxygen environment vs 130 ± 63 (median, 136; range, 16-252) with nasal cannula (P = .002). Infants on oxygen environment compared with nasal cannula also had decreased episodes of severe intermittent hypoxemia (P = .005). Infants on oxygen environment compared with nasal cannula had a lower proportion of time with oxygen saturations <85% (.05 ± .03 vs .06 ± .03, P < .001), and a lower coefficient of variation of oxygen saturation (P = .02).
Conclusions |
In preterm infants receiving supplemental oxygen, servo-controlled oxygen environment decreases hypoxemia compared with nasal cannula.
Trial registration |
ClinicalTrials.gov: NCT02794662.
Le texte complet de cet article est disponible en PDF.Keywords : intermittent hypoxemia, respiratory distress syndrome, bronchopulmonary dysplasia, servo-controlled, incubator, supplemental, infant, newborn, neonate, neonatal
Abbreviations : FiO2, SpO2
Plan
| Supported by the Agency for Healthcare Research and Quality (5T32HS013852-14 [to C.T.]); the National Institutes of Health (U01 HL133536 [to N.A. and P.I.]); the Dixon Fellowship of the University of Alabama at Birmingham and Children's of Alabama [to C.T.]; and the National Science Foundation, Smart and Connected Health (IIS 1664815 [to P.I.]). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality, the National Institute of Health, or the National Science Foundation. These funders had no role in the study design; the collection, analysis, or interpretation of data; the writing of the report; or in the decision to submit the article for publication. W.C. serves on the Board of Directors of MEDNAX, Inc. The other authors declare no conflicts of interest. |
Vol 200
P. 98-103 - septembre 2018 Retour au numéro
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