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Comparison of volume guarantee and volume-controlled ventilation both using closed loop inspired oxygen in preterm infants: A randomised crossover study (CLIO-VG study)

Lookup NU author(s): Dr Vrinda Nair, Dr Mithilesh Lal, Dr Prakash Kannan Loganathan


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© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.Objective: The objective of this study was to compare two different modes of ventilation in maintaining oxygen saturation (SpO2) in target range (90%-95%) in ventilated preterm infants cared for with automatic control of oxygen delivery (A-FiO2). Design: A single-centre randomised crossover study. Settings: A level III neonatal intensive care unit. Patients: Preterm infants receiving mechanical ventilation and oxygen requirement >21%. Interventions: Volume guarantee (VG) vs volume controlled ventilation (VCV) modes with automatic oxygen control (A-FiO2). Outcomes: The primary outcome of this study was the proportion of time spent with oxygen saturations in the target range (90%-95%). Results: Nineteen preterm infants with a median gestation age 25 weeks (IQR: 24-28) and birth weight 685 g (IQR: 595-980) were enrolled in the study. There was no significant difference in primary outcome of median proportion of time spent in target saturation between the two arms (72% (57-81) in VG vs 75% (58-83) in VCV; p=0.98). There was no significant difference in the secondary outcomes of time spent in SpO2 <80% (0.03% vs 0.14%; p=0.51), time spent in SpO2 >98% (0.50% vs 0.08%; p=0.54), the median FiO2 (31% vs 29%; p=0.51) or manual adjustments carried out between VG and VCV, respectively. The number of episodes of prolonged hypoxaemia and hyperoxaemia were similar in the two groups. Conclusion: There was no significant difference in time spent in target SpO2 range between VG and VCV when A-FiO2 was used as the FiO2 controller in this crossover randomised control study. Trial registration number: NCT03865069.

Publication metadata

Author(s): Nair V, Lal MK, Gillone J, Kannan Loganathan P, Bachman TE

Publication type: Article

Publication status: Published

Journal: Archives of Disease in Childhood: Fetal and Neonatal Edition

Year: 2021

Pages: epub ahead of print

Online publication date: 07/07/2021

Acceptance date: 18/06/2021

ISSN (print): 1359-2998

ISSN (electronic): 1468-2052

Publisher: BMJ Publishing Group


DOI: 10.1136/archdischild-2021-321712


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