Predictive Intelligent Control of Oxygenation (PRICO) in preterm infants on high flow nasal cannula support: A randomised cross-over study

Koen P. Dijkman*, Thilo Mohns, Jeanne P. Dieleman, Carola Van Pul, Tom G. Goos, Irwin K.M. Reiss, Peter Andriessen, Hendrik J. Niemarkt

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

17 Citations (Scopus)

Abstract

Objective To investigate the efficacy of automated control of inspired oxygen (FiO2) by Predictive Intelligent Control of Oxygenation (PRICO) on the Fabian ventilator in maintaining oxygen saturation (SpO2) in preterm infants on high flow nasal cannula (HFNC) support. Design Single-centre randomised two-period crossover study. Setting Tertiary neonatal intensive care unit. Patients 27 preterm infants (gestational age (GA) <30 weeks) on HFNC support with FiO2 >0.25. Intervention A 24-hour period on automated FiO2-control with PRICO compared with a 24-hour period on routine manual control (RMC) to maintain a SpO2 level within target range of 88%-95% measured at 30 s intervals. Main outcome measures Primary outcome: time spent within target range (88%-95%). Secondary outcomes: time spent above and below target range, in severe hypoxia (SpO2 <80%) and hyperoxia (SpO2 >98%), mean SpO2 and FiO2 and manual FiO2 adjustments. Results 15 patients received PRICO-RMC and 12 RMC-PRICO. The mean time within the target range increased with PRICO: 10.8% (95% CI 7.6 to 13.9). There was a decrease in time below target range: 7.6% (95% CI 4.2 to 11.0), above target range: 3.1% (95% CI 2.9 to 6.2) and in severe hypoxia: 0.9% (95% CI 1.5 to 0.2). We found no difference in time spent in severe hyperoxia. Mean FiO2 was higher during PRICO: 0.019 (95% CI 0.006 to 0.030). With PRICO there was a reduction of manual adjustments: 9/24 hours (95% CI 6 to 12). Conclusion In preterm infants on HFNC support, automated FiO2-control by PRICO is superior to RMC in maintaining SpO2 within target range. Further validation studies with a higher sample frequency and different ventilation modes are needed.

Original languageEnglish
Pages (from-to)F621-F626
JournalArchives of Disease in Childhood: Fetal and Neonatal Edition
Volume106
Issue number6
DOIs
Publication statusPublished - 1 Nov 2021

Bibliographical note

Funding Information:
Funding This study was supported by an unrestricted research grant from Chiesi Pharmaceuticals BV, The Netherlands.

Publisher Copyright:
© Author(s) (or their employer(s)) 2021.

Research programs

  • EMC MM-03-54-04-A

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