Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

BackgroundWe aimed to assess the efficacy of a closed-loop oxygen control in critically ill patients with moderate to severe acute hypoxemic respiratory failure (AHRF) treated with high flow nasal oxygen (HFNO).MethodsIn this single-centre, single-blinded, randomized crossover study, adult patients with moderate to severe AHRF who were treated with HFNO (flow rate ≥ 40 L/min with FiO2 ≥ 0.30) were randomly assigned to start with a 4-h period of closed-loop oxygen control or 4-h period of manual oxygen titration, after which each patient was switched to the alternate therapy. The primary outcome was the percentage of time spent in the individualized optimal SpO2 range.ResultsForty-five patients were included. Patients spent more time in the optimal SpO2 range with closed-loop oxygen control compared with manual titrations of oxygen (96.5 [93.5 to 98.9] % vs. 89 [77.4 to 95.9] %; p 2 range, and less time above the suboptimal range. Fewer number of manual adjustments per hour were needed with closed-loop oxygen control. The number of events of SpO2 ConclusionsClosed-loop oxygen control improves oxygen administration in patients with moderate-to-severe AHRF treated with HFNO, increasing the percentage of time in the optimal oxygenation range and decreasing the workload of healthcare personnel. These results are especially relevant in a context of limited oxygen supply and high medical demand, such as the COVID-19 pandemic. Trial registration The HILOOP study was registered at www.Clinicaltrialsgov under the identifier NCT04965844 .

Original publication

DOI

10.1186/s13054-022-03970-w

Type

Journal article

Journal

Critical care (London, England)

Publication Date

04/2022

Volume

26

Addresses

Servei de Medicina Intensiva, Hospital Universitari Vall d'Hebron and Institut de Recerca Vall d'Hebron, Pg Vall d'Hebron 119-129, 08035, Barcelona, Spain. oroca@vhebron.net.

Keywords

Humans, Respiratory Insufficiency, Oxygen, Oxygen Inhalation Therapy, Cross-Over Studies, Adult, Pandemics, Hypoxia, Cannula, COVID-19