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An Observational Study to Quantify Manual Adjustments of the Inspired Oxygen Fraction in Extremely Low Birth Weight Infants.
MedLine Citation:
PMID:  22040264     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim:  To quantify manual FiO(2) adjustments performed by caregivers in extremely low birth weight (ELBW; ≤1000 gram) infants, in relation to oxygen saturation (SpO(2) ), and bedside care. Methods:  In a single-centre study, FiO(2) , SpO(2) , and alarm limits of ELBW infants were collected for 3 days continuously, while caregivers were filmed. A descriptive analysis, focused on manual FiO(2) adjustments, was performed. Results:  Twelve ELWB infants were included. Total recording time was 726 hours. FiO(2) was increased 851 times and decreased 1309 times; median (range) step size was 5% (1% to 65%) and -3% (-1% to -65%), respectively. Wide variation of FiO(2) adjustments for equal levels of SpO(2) was observed in all included infants. 126 of 136 FiO(2) adjustments with a step size ≥15% and 111 of 171 desaturations <70% were associated with medical or nursing procedures. When FiO(2) was >21%, alarm limits for SpO(2) were set according to protocol (88-94%) in 64% of the time. Within these periods, SpO(2) was >94% for 30% and <88% for 16% of the time. Conclusions:  Manual FiO(2) adjustments varied widely in frequency and step size. Deep desaturations and large FiO(2) adjustments were associated with medical or nursing procedures. When large adjustments are really necessary, it will be challenging to implement them in an automatic adjustment device.
Authors:
Anne Catherine van der Eijk; Jenny Dankelman; Sander Schutte; Huibert Jan Simonsz; Bert Johan Smit
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-31
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  -     ISSN:  1651-2227     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-11-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Acta Paediatrica © 2011 Foundation Acta Paediatrica.
Affiliation:
Department of BioMechanical Engineering, Faculty of Mechanical, Maritime & Materials Engineering, Delft University of Technology, Delft, The Netherlands Department of Ophthalmology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands Department of Neonatology, Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
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