Effectiveness of automatic FiO₂ control devices in the neonatal intensive care unit: a literature review

Introduction: respiratory failure in newborns frequently requires oxygen therapy as a fundamental intervention. However, the use of high concentrations of oxygen exposes the newborn to high oxidative stress and increases the risk of developing numerous chronic conditions. This article aims to summarize the scientific literature on the actual effectiveness of devices for the automatic management of delivered FiO2, specifically the actual effectiveness of this technology in maintaining the patient within predefined saturation targets while reducing periods of hyperoxia or hypoxia.

Materials and Methods: a literature review was conducted using the online databases Medline (for PubMed), the Cochrane Library, and EBSCO (for CINAHL). Articles addressing outcomes other than the efficacy criteria of the research objective were excluded; only English-language articles published within the last 10 years were selected.

Results: the literature indicates that the use of devices for automatic FiO₂ titration in newborns receiving oxygen therapy increased the time spent within the set saturation target range, thereby reducing periods of hypoxia or hyperoxia.

Conclusions: this review demonstrates the effectiveness of automatic devices (Closed-Loop Automated Oxygen Control, CLAC). Further studies are needed to identify an optimal target saturation range, in order to properly guide clinical practice in oxygen administration. Although the use of CLAC has been shown to be effective in maintaining normal saturation targets, further follow-up studies are needed to demonstrate that the use of CLAC is truly effective in reducing hyperoxia-related complications.