Skip to main content

Automated Control of Oxygen in Neonates

  • Chapter
  • First Online:
Pediatric and Neonatal Mechanical Ventilation

Abstract

Supplemental oxygen is given to a large proportion of preterm infants to maintain adequate levels of oxygenation. In this population exposure to supplemental oxygen increases the risk of retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and oxygen radical injury to other organs and systems (McColm and Fleck 2001; Tin and Gupta 2007; Saugstad 2003). These effects are more pronounced in infants born at earlier gestational ages due to their immaturity and the prolonged duration of the exposure to oxygen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Beddis JR, Collins P, Levy NM, Godfrey S, Silverman M (1979) New technique for servo-control of arterial oxygen tension in preterm infants. Arch Dis Child 54:278–280

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Bhutani VK, Taube JC, Antunes MJ, Delivoria-Papadopoulos M (1992) Adaptive control of the inspired oxygen delivery to the neonate. Pediatr Pulmonol 14:110–117

    Article  CAS  PubMed  Google Scholar 

  • Bohnhorst B, Peter CS, Poets CF (2000) Pulse oximeters’ reliability in detecting hypoxemia and bradycardia: comparison between a conventional and two new generation oximeters. Crit Care Med 28:1565–1568

    Article  CAS  PubMed  Google Scholar 

  • Bolivar JM, Gerhardt T, Gonzalez A, Hummler H, Claure N, Everett R, Bancalari E (1995) Mechanisms for episodes of hypoxemia in preterm infants undergoing mechanical ventilation. J Pediatr 127:767–773

    Article  CAS  PubMed  Google Scholar 

  • Bucher HU, Keel M, Wolf M, von Siebenthal K, Duc G (1994) Artifactual pulse-oximetry estimation in neonates. Lancet 343:1135–1136

    Article  CAS  PubMed  Google Scholar 

  • Chow LC, Wright KW, Sola A, CSMC Oxygen Administration Study Group (2003) Can changes in clinical practice decrease the incidence of severe retinopathy of prematurity in very low birth weight infants? Pediatrics 111:339–345

    Article  PubMed  Google Scholar 

  • Claure N, Gerhardt T, Everett R, Musante G, Herrera C, Bancalari E (2001) Closed-loop controlled inspired oxygen concentration for mechanically ventilated very low birth weight infants with frequent episodes of hypoxemia. Pediatrics 107:1120–1124

    Article  CAS  PubMed  Google Scholar 

  • Claure N, D’Ugard C, Bancalari E (2009) Automated adjustment of inspired oxygen in preterm infants with frequent fluctuations in oxygenation: a pilot clinical trial. J Pediatr 155:640–645

    Article  PubMed  Google Scholar 

  • Claure N, Bancalari E, D’Ugard C, Nelin L, Stein M, Ramanathan R, Hernandez R, Donn SM, Becker M, Bachman T (2011) Multicenter crossover study of automated adjustment of inspired oxygen in mechanically ventilated preterm infants. Pediatrics 127:e76–e83

    Article  PubMed  Google Scholar 

  • Clucas L, Doyle LW, Dawson J, Donath S, Davis PG (2007) Compliance with alarm limits for pulse oximetry in very preterm infants. Pediatrics 119:1056–1060

    Article  PubMed  Google Scholar 

  • Dimaguila MA, DiFiore JA, Martin R, Miller MJ (1997) Characteristics of hypoxemic episodes in very low birth weight infants on ventilatory support. J Pediatr 130:577–583

    Article  CAS  PubMed  Google Scholar 

  • Dugdale RE, Cameron RG, Lealman GT (1988) Closed-loop control of the partial pressure of arterial oxygen in neonates. Clin Phys Physiol Meas 9:291–305

    Article  CAS  PubMed  Google Scholar 

  • Esquer C, Claure N, D’Ugard C, Wada Y, Bancalari E (2007) The role of abdominal muscle activity on the duration and severity of hypoxemia episodes in mechanically ventilated preterm infants. Neonatology 92:182–186

    Article  PubMed  Google Scholar 

  • Hagadorn JI, Furey AM, Nghiem TH, Schmid CH, Phelps DL, Pillers DA, Cole CH, AVIOx Study Group (2006) Achieved versus intended pulse oximeter saturation in infants born less than 28 weeks’ gestation: the AVIOx study. Pediatrics 118:1574–1582

    Article  PubMed  Google Scholar 

  • Hay WW Jr, Rodden DJ, Collins SM, Melara DL, Hale KA, Fashaw LM (2002) Reliability of conventional and new pulse oximetry in neonatal patients. J Perinatol 22:360–366

    Article  PubMed  Google Scholar 

  • Laptook AR, Salhab W, Allen J, Saha S, Walsh M (2006) Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range? J Perinatol 26:337–341

    Article  CAS  PubMed  Google Scholar 

  • Lehtonen L, Johnson MW, Bakdash T, Martin RJ, Miller MJ, Scher M (2002) Relation of sleep state to hypoxemic episodes in ventilated extremely-low-birth-weight infants. J Pediatr 141:363–369

    Article  PubMed  Google Scholar 

  • McColm JR, Fleck BW (2001) Retinopathy of prematurity: causation. Semin Neonatol 6:453–460

    Article  CAS  PubMed  Google Scholar 

  • Morozoff PE, Evans RW (1992) Closed-loop control of SaO2 in the neonate. Biomed Instrum Technol 26:117–123

    CAS  PubMed  Google Scholar 

  • Nghiem TH, Hagadorn JI, Terrin N, Syke S, MacKinnon B, Cole CH (2008) Nurse opinions and pulse oximeter saturation target limits for preterm infants. Pediatrics 121:e1039–e1046

    Article  PubMed  Google Scholar 

  • Saugstad OD (2003) Bronchopulmonary dysplasia-oxidative stress and oxidants. Semin Neonatol 8:39–49

    Article  PubMed  Google Scholar 

  • Sun Y, Kohane IS, Stark AR (1997) Computer-assisted adjustment of inspired oxygen concentration improves control of oxygen saturation in newborn infants requiring mechanical ventilation. J Pediatr 131:754–756

    Article  CAS  PubMed  Google Scholar 

  • SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network, Carlo WA, Finer NN, Walsh MC et al (2010) Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med 362:1959–1969

    Article  CAS  PubMed  Google Scholar 

  • Tin W, Gupta S (2007) Optimum oxygen therapy in preterm babies. Arch Dis Child Fetal Neonatal Ed 92:F143–F147

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Tin W, Milligan DW, Pennefather P, Hey E (2001) Pulse oximetry, severe retinopathy, and outcome at one year in babies of less than 28 weeks gestation. Arch Dis Child Fetal Neonatal Ed 84:F106–F110

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Urschitz MS, Horn W, Seyfang A, Hallenberger A, Herberts T, Miksch S, Popow C, Müller-Hansen I, Poets CF (2004) Automatic control of the inspired oxygen fraction in preterm infants: a randomized crossover trial. Am J Respir Crit Care Med 170:1095–1100

    Article  PubMed  Google Scholar 

  • Vanderveen DK, Mansfield TA, Eichenwald EC (2006) Lower oxygen saturation alarm limits decrease the severity of retinopathy of prematurity. J AAPOS 10:445–448

    Article  PubMed  Google Scholar 

  • Wright KW, Sami D, Thompson L, Ramanathan R, Joseph R, Farzavandi S (2006) A physiologic reduced oxygen protocol decreases the incidence of threshold retinopathy of prematurity. Trans Am Ophthalmol Soc 104:78–84

    PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nelson Claure MSc, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Claure, N., Bancalari, E. (2015). Automated Control of Oxygen in Neonates. In: Rimensberger, P. (eds) Pediatric and Neonatal Mechanical Ventilation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-01219-8_60

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-01219-8_60

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-01218-1

  • Online ISBN: 978-3-642-01219-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics