Automated oxygen control versus manual titration in preterm infants: A systematic review and meta-analysis
- Journal
- Journal of perinatology : official journal of the California Perinatal Association (Q1)
- Published
- 30 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Mohammad Amouri, Salahaldeen Deeb, Nouraldeen Deeb, Ayshe M Zoabi, Alhareth M Amro, Ahmed Rayyan, et al.
- PMID
- 42533062
- DOI
- 10.1038/s41372-026-02842-3
Why clinicians should know about it
- Picked for Neonatology (top studies of the week, 2 August 2026).
- Picked for Pediatrics and Child Health (top studies of the week, 2 August 2026).
Abstract
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.