Louis W. Kirton MBChB , Raulle Sol Cruz BSN , Leanlove Navarra BSN , Allie Eathorne BSc , Julie Cook MBChB , Richard Beasley DSc , Paul J. Young MBChB, PhD
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Young MBChB, PhD","doi":"10.1016/j.ccrj.2024.01.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this study was to determine whether automated titration of the fraction of inspired oxygen (FiO<sub>2</sub>) increases the time spent with oxygen saturation (SpO<sub>2</sub>) within a predetermined target SpO<sub>2</sub> range compared with manually adjusted high-flow oxygen therapy in postoperative cardiac surgical patients managed in the intensive care unit (ICU).</p></div><div><h3>Design</h3><p>Single-centre, open-label, randomised clinical trial.</p></div><div><h3>Setting</h3><p>Tertiary centre ICU.</p></div><div><h3>Participants</h3><p>Recently extubated adults following elective cardiac surgery who required supplemental oxygen.</p></div><div><h3>Interventions</h3><p>Automatically adjusted FiO<sub>2</sub> (using an automated oxygen control system) compared with manual FiO<sub>2</sub> titration, until cessation of oxygen therapy, ICU discharge, or 24 h (whichever was sooner).</p></div><div><h3>Main outcome measures</h3><p>The primary outcome was the proportion of time receiving oxygen therapy with the SpO<sub>2</sub> in a SpO<sub>2</sub> target range of 92–96 %.</p></div><div><h3>Results</h3><p>Among 65 participants, the percentage of time per patient spent in the target SpO<sub>2</sub> range was a median of 97.7 % (interquartile range: 87.9–99.2 %) and 91.3 % (interquartile range: 77.1–96.1 %) in the automated (n = 28) and manual (n = 28) titration groups, respectively. The estimated effect of automated FiO<sub>2</sub>, compared to manual FiO<sub>2</sub> titration, was to increase the percentage of time spent in the target range by a median of 4.8 percentage points (95 % confidence interval: 1.6 to 10.3 percentage points, p = 0.01).</p></div><div><h3>Conclusion</h3><p>In patients recently extubated after cardiac surgery, automated FiO<sub>2</sub> titration significantly increased time spent in a target SpO<sub>2</sub> range of 92–96 % compared to manual FiO<sub>2</sub> titration.</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277224000012/pdfft?md5=d919093c4ea4da4a465fbf8f92c3ea67&pid=1-s2.0-S1441277224000012-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Effect of automated titration of oxygen on time spent in a prescribed oxygen saturation range in adults in the ICU after cardiac surgery\",\"authors\":\"Louis W. 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Young MBChB, PhD\",\"doi\":\"10.1016/j.ccrj.2024.01.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>The objective of this study was to determine whether automated titration of the fraction of inspired oxygen (FiO<sub>2</sub>) increases the time spent with oxygen saturation (SpO<sub>2</sub>) within a predetermined target SpO<sub>2</sub> range compared with manually adjusted high-flow oxygen therapy in postoperative cardiac surgical patients managed in the intensive care unit (ICU).</p></div><div><h3>Design</h3><p>Single-centre, open-label, randomised clinical trial.</p></div><div><h3>Setting</h3><p>Tertiary centre ICU.</p></div><div><h3>Participants</h3><p>Recently extubated adults following elective cardiac surgery who required supplemental oxygen.</p></div><div><h3>Interventions</h3><p>Automatically adjusted FiO<sub>2</sub> (using an automated oxygen control system) compared with manual FiO<sub>2</sub> titration, until cessation of oxygen therapy, ICU discharge, or 24 h (whichever was sooner).</p></div><div><h3>Main outcome measures</h3><p>The primary outcome was the proportion of time receiving oxygen therapy with the SpO<sub>2</sub> in a SpO<sub>2</sub> target range of 92–96 %.</p></div><div><h3>Results</h3><p>Among 65 participants, the percentage of time per patient spent in the target SpO<sub>2</sub> range was a median of 97.7 % (interquartile range: 87.9–99.2 %) and 91.3 % (interquartile range: 77.1–96.1 %) in the automated (n = 28) and manual (n = 28) titration groups, respectively. 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Effect of automated titration of oxygen on time spent in a prescribed oxygen saturation range in adults in the ICU after cardiac surgery
Objective
The objective of this study was to determine whether automated titration of the fraction of inspired oxygen (FiO2) increases the time spent with oxygen saturation (SpO2) within a predetermined target SpO2 range compared with manually adjusted high-flow oxygen therapy in postoperative cardiac surgical patients managed in the intensive care unit (ICU).
Recently extubated adults following elective cardiac surgery who required supplemental oxygen.
Interventions
Automatically adjusted FiO2 (using an automated oxygen control system) compared with manual FiO2 titration, until cessation of oxygen therapy, ICU discharge, or 24 h (whichever was sooner).
Main outcome measures
The primary outcome was the proportion of time receiving oxygen therapy with the SpO2 in a SpO2 target range of 92–96 %.
Results
Among 65 participants, the percentage of time per patient spent in the target SpO2 range was a median of 97.7 % (interquartile range: 87.9–99.2 %) and 91.3 % (interquartile range: 77.1–96.1 %) in the automated (n = 28) and manual (n = 28) titration groups, respectively. The estimated effect of automated FiO2, compared to manual FiO2 titration, was to increase the percentage of time spent in the target range by a median of 4.8 percentage points (95 % confidence interval: 1.6 to 10.3 percentage points, p = 0.01).
Conclusion
In patients recently extubated after cardiac surgery, automated FiO2 titration significantly increased time spent in a target SpO2 range of 92–96 % compared to manual FiO2 titration.
期刊介绍:
ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines.
The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world.
The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.