THE ADOPTION OF AUTOMATED FiO2 CONTROL INTO POLISH NICUS: 2012–2019

Souhrn

The introduction and adoption of new technology in medicine is a continuous ever present process but it is often not studied. Insights gained from documenting such experiences can not only guide local practices but also provide valuable quality benchmarks. Automated control of FiO₂ based on continuous SpO₂ (A-FiO₂) not only reduces the challenging task of manual oxygen titration, but also has the potential to greatly improve the morbidity and mortality of extremely preterm infants. First approved for use in Europe in 2012, it is now available on most infant ventilators outside the USA. Poland was the first region in Europe to implement its clinical use. We report experience from 619 infants from 12 centers recorded in a web-based registry established in 2013 to document its use. We found the A-FiO₂ was primarily used in the first week of life in intubated infants. However it is also successfully applied in both noninvasively supported infants and in those who were difficult to wean from oxygen and who exhibited frequent desaturations. We also found the SpO₂ target range and alarm setting are not different from normal manual titration, although wider settings are also used and promise some benefit. Finally we report our plan to gather data from a national data base and detailed surveys. The surveys will document subjective aspects of this experience from a core group of centers. Details of the surveys are included and cover: experience with training and acceptance, changes in practice associated with the years of experience and barriers to broader use.