CROSSOVER FROM AUTOMATED TO MANUAL TITRATION OF FiO2 IN THE NICU: IS THERE A TRANSITION LAG?

Thomas Bachman, Karel Roubik

Abstract


Effective management of oxygenation of preterm infants in critical care profoundly impacts their outcome. Nurses are challenged to titrate the inspired oxygen in response to constant cardiopulmonary instability. Closed loop control of inspired oxygen based on continuous monitoring of oxygen saturation is just becoming available. Evaluating the relative effectiveness of closed loop control systems is complicated by the wide variability in manual control by nurses. This analysis explored the possibility of a lag in effective control associated with the transition from closed loop to manual control using data from a clinical crossover trial. A short but marked lag phase was detected. It is, however, unlikely to have impact on clinical care or crossover studies. Its presence highlights the anticipative nature of closed loop control as contrasted to the observative nature of manual control.


Keywords


neonatal critical care; oxygen control; closed loop oxygen control

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This work is licensed under a Creative Commons Attribution 4.0 International License.

ISSN 0301-5491 (Print)
ISSN 2336-5552 (Online)
Published by the Czech Society for Biomedical Engineering and Medical Informatics and the Faculty of Biomedical Engineering, Czech Technical University in Prague.