Automated oxygen control with O2matic ® during admission with exacerbation of COPD

• Published in: International journal of chronic obstructive pulmonary disease Vol. 13; pp. 3997 - 4003
• Main Authors: Hansen, Ejvind Frausing, Hove, Jens Dahlgaard, Bech, Charlotte Sandau, Jensen, Jens-Ulrik Stæhr, Kallemose, Thomas, Vestbo, Jørgen
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Ltd 01.01.2018; Dove Medical Press
• Subjects: Aged; Aged, 80 and over; Automation; Chronic obstructive pulmonary disease; Closed loop systems; closed-loop; Cross-Over Studies; Denmark; Disease Progression; Equipment Design; Female; Forced Expiratory Volume; Humans; Hyperoxia; Hypoxia; Lung - physiopathology; Male; Middle Aged; Nursing; Original Research; Oximetry; Oxygen Inhalation Therapy - instrumentation; oxygen saturation; oxygen therapy; Patient Admission; Patient safety; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Pulse oximetry; Sensors; Time Factors; Treatment Outcome; Ventilation; Denmark; hypoxia; closed-loop; oxygen saturation; hyperoxia; oxygen therapy
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S183762

It is a challenge to control oxygen saturation (SpO ) in patients with exacerbations of COPD during admission. We tested a newly developed closed-loop system, O2matic , and its ability to keep SpO within a specified interval compared with manual control by nursing staff. We conducted a crossover trial with patients admitted with an exacerbation of COPD and hypoxemia (SpO ≤88% on room air). Patients were monitored with continuous measurement of SpO . In random order, they had 4 hours with manually controlled oxygen and 4 hours with oxygen delivery controlled by O2matic. Primary outcome was time within a prespecified SpO target interval. Secondary outcomes were time with SpO <85%, time with SpO below target but not <85%, and time with SpO above target. Twenty patients were randomized and 19 completed the study. Mean age was 72.4 years and mean FEV was 0.72 L (33% of predicted). Patients with O2matic-controlled treatment were within the SpO target interval in 85.1% of the time vs 46.6% with manually controlled treatment ( <0.001). Time with SpO <85% was 1.3% with O2matic and 17.9% with manual control ( =0.01). Time with SpO below target but not <85% was 9.0% with O2matic and 25.0% with manual control ( =0.002). Time with SpO above target was not significantly different between treatments (4.6% vs 10.5%, =0.2). Patients expressed high confidence and a sense of safety with automatic oxygen delivery. O2matic was able to effectively control SpO for patients admitted with an exacerbation of COPD. O2matic was significantly better than manual control to maintain SpO within target interval and to reduce time with unintended hypoxemia.