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Objective <p>To evaluate whether closed-loop automated fraction of inspired oxygen (FiO2) control improves oxygen targeting and clinical outcomes compared with clinician-directed manual titration in preterm infants.</p> Study design <p>Systematic review and random-effects meta-analysis of randomized trials searched through Feb 6, 2026. Crossover and parallel-group trials informed physiological outcomes; only longitudinal parallel-group trials informed clinical outcomes.</p> Results <p>Twenty-three trials (1777 infants) were included. Automated control increased time within target range (mean difference 15.01 percentage points, 95% CI 10.90 to 19.13) and reduced time above target, below target, SpO2 &lt; 80%, SpO2 &gt; 98%, and manual FiO2 adjustments. Clinical outcomes remained uncertain: bronchopulmonary dysplasia risk ratio 0.80, death 1.03, necrotizing enterocolitis 0.81, and treatment-requiring retinopathy of prematurity 0.90.</p> Conclusion <p>Automated FiO2 control consistently improves oxygen targeting, but current randomized evidence does not show clear benefit for major neonatal outcomes.</p>

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Automated oxygen control versus manual titration in preterm infants: A systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年7月30日

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  • Mohammad Amouri,
  • Salahaldeen Deeb,
  • Nouraldeen Deeb,
  • Ayshe M. Zoabi,
  • Alhareth M. Amro,
  • Ahmed Rayyan,
  • Motee Abuawwad

摘要

Objective

To evaluate whether closed-loop automated fraction of inspired oxygen (FiO2) control improves oxygen targeting and clinical outcomes compared with clinician-directed manual titration in preterm infants.

Study design

Systematic review and random-effects meta-analysis of randomized trials searched through Feb 6, 2026. Crossover and parallel-group trials informed physiological outcomes; only longitudinal parallel-group trials informed clinical outcomes.

Results

Twenty-three trials (1777 infants) were included. Automated control increased time within target range (mean difference 15.01 percentage points, 95% CI 10.90 to 19.13) and reduced time above target, below target, SpO2 < 80%, SpO2 > 98%, and manual FiO2 adjustments. Clinical outcomes remained uncertain: bronchopulmonary dysplasia risk ratio 0.80, death 1.03, necrotizing enterocolitis 0.81, and treatment-requiring retinopathy of prematurity 0.90.

Conclusion

Automated FiO2 control consistently improves oxygen targeting, but current randomized evidence does not show clear benefit for major neonatal outcomes.