Abstract
<p>Oxygen therapy is an essential treatment of premature infants suffering from hypoxemia. Normoxemia is maintained by an adjustment of the fraction of oxygen (FiO<sub>2</sub>) in the inhaled gas mixture that is set manually or automatically based on peripheral oxygen saturation (SpO<sub>2</sub>). Automatic closed-loop systems could be more successful in controlling SpO<sub>2</sub> than traditional manual approaches. Computer models of neonatal oxygen transport have been developed as a tool for design, validation, and comparison of the automatic control algorithms. The aim of this study was to investigate and implement the time delay of oxygen delivery after a change of set FiO<sub>2</sub> during noninvasive ventilation support to enhance an available mathematical model of neonatal oxygen transport. The time delay of oxygen delivery after the change of FiO<sub>2</sub> during the noninvasive nasal Continuous Positive Airway Pressure (nCPAP) ventilation support and during the High Flow High Humidity Nasal Cannula (HFHHNC) ventilation support was experimentally measured using an electromechanical gas blender and a physical model of neonatal lungs. Results show the overall time delay of the change in the oxygen fraction can be divided into the baseline of delay, with a typical time delay 5.5 s for nCPAP and 6.5 s for HFHHNC s, and an exponential rising phase with a time constant about 2–3 s. A delay subsystem was implemented into the mathematical model for a more realistic performance when simulating closed-loop control of oxygenation.</p>
Highlights
Oxygen therapy is an essential treatment of premature infants suffering from hypoxemia due to the underdevelopment of the nervous, respiratory or cardiovascular system [1, 2]
The range of parameters a and τ is considerably wider for High Flow High Humidity Nasal Cannula (HFHHNC) data than for nasal Continuous Positive Airway Pressure (nCPAP) data
In this work we focused on the time delay of oxygen delivery after the change of set FiO2 in respiratory support systems with internal electronic gas blenders
Summary
Oxygen therapy is an essential treatment of premature infants suffering from hypoxemia due to the underdevelopment of the nervous, respiratory or cardiovascular system [1, 2]. Hypoxemia leads to insufficient oxygenation of tissues, hypoxia, and consequent slow development of vital organs. FiO2 is adjusted manually based on peripheral oxygen saturation (SpO2) measured by pulse oximetry. Is the manual control of oxygenation time consuming, but several studies documented that clinical staff often fails to keep SpO2 within the required range, sometimes even more than 50% of the time [4, 5]. Automatic closed-loop systems that adjust FiO2 continuously could be more successful in controlling SpO2 and assuring required levels of oxygenation in premature infants [6,7,8]
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