TY - JOUR

T1 - Automated oxygen control with O2matic® during admission with exacerbation of COPD

AU - Hansen, Ejvind Frausing

AU - Hove, Jens Dahlgaard

AU - Bech, Charlotte Sandau

AU - Jensen, Jens Ulrik Stæhr

AU - Kallemose, Thomas

AU - Vestbo, Jørgen

PY - 2018

Y1 - 2018

N2 - It is a challenge to control oxygen saturation (SpO 2 ) in patients with exacerbations of COPD during admission. We tested a newly developed closed-loop system, O2matic®, and its ability to keep SpO 2 within a specified interval compared with manual control by nursing staff. Patients and methods: We conducted a crossover trial with patients admitted with an exacerbation of COPD and hypoxemia (SpO 2 ≤88% on room air). Patients were monitored with continuous measurement of SpO 2 . In random order, they had 4 hours with manually controlled oxygen and 4 hours with oxygen delivery controlled by O2matic. Primary outcome was time within a prespecified SpO 2 target interval. Secondary outcomes were time with SpO 2 <85%, time with SpO 2 below target but not <85%, and time with SpO 2 above target. Results: Twenty patients were randomized and 19 completed the study. Mean age was 72.4 years and mean FEV1 was 0.72 L (33% of predicted). Patients with O2matic-controlled treatment were within the SpOF target interval in 85.1% of the time vs 46.6% with manually controlled treatment (P<0.001). Time with SpO 2 <85% was 1.3% with O2matic and 17.9% with manual control (P=0.01). Time with SpO 2 below target but not <85% was 9.0% with O2matic and 25.0% with manual control (P=0.002). Time with SpO 2 above target was not significantly different between treatments (4.6% vs 10.5%, P=0.2). Patients expressed high confidence and a sense of safety with automatic oxygen delivery. Conclusion: O2matic was able to effectively control SpO 2 for patients admitted with an exacerbation of COPD. O2matic was significantly better than manual control to maintain SpO 2 within target interval and to reduce time with unintended hypoxemia.

AB - It is a challenge to control oxygen saturation (SpO 2 ) in patients with exacerbations of COPD during admission. We tested a newly developed closed-loop system, O2matic®, and its ability to keep SpO 2 within a specified interval compared with manual control by nursing staff. Patients and methods: We conducted a crossover trial with patients admitted with an exacerbation of COPD and hypoxemia (SpO 2 ≤88% on room air). Patients were monitored with continuous measurement of SpO 2 . In random order, they had 4 hours with manually controlled oxygen and 4 hours with oxygen delivery controlled by O2matic. Primary outcome was time within a prespecified SpO 2 target interval. Secondary outcomes were time with SpO 2 <85%, time with SpO 2 below target but not <85%, and time with SpO 2 above target. Results: Twenty patients were randomized and 19 completed the study. Mean age was 72.4 years and mean FEV1 was 0.72 L (33% of predicted). Patients with O2matic-controlled treatment were within the SpOF target interval in 85.1% of the time vs 46.6% with manually controlled treatment (P<0.001). Time with SpO 2 <85% was 1.3% with O2matic and 17.9% with manual control (P=0.01). Time with SpO 2 below target but not <85% was 9.0% with O2matic and 25.0% with manual control (P=0.002). Time with SpO 2 above target was not significantly different between treatments (4.6% vs 10.5%, P=0.2). Patients expressed high confidence and a sense of safety with automatic oxygen delivery. Conclusion: O2matic was able to effectively control SpO 2 for patients admitted with an exacerbation of COPD. O2matic was significantly better than manual control to maintain SpO 2 within target interval and to reduce time with unintended hypoxemia.

KW - Closed-loop

KW - Hyperoxia

KW - Hypoxia

KW - Oxygen saturation

KW - Oxygen therapy

U2 - 10.2147/COPD.S183762

DO - 10.2147/COPD.S183762

M3 - Journal article

C2 - 30587955

AN - SCOPUS:85059245617

VL - 13

SP - 3997

EP - 4003

JO - International Journal of COPD

JF - International Journal of COPD

SN - 1176-9106

ER -