Predictive Intelligent Control of Oxygenation (PRICO) in preterm infants on high flow nasal cannula support: a randomised cross-over study

Koen P. Dijkman (Corresponding author), Thilo Mohns, Jeanne P. Dieleman, Carola van Pul, Tom G. Goos, Irwin K.M. Reiss, Peter Andriessen, Hendrik J. Niemarkt

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

15 Citaten (Scopus)


OBJECTIVE: To investigate the efficacy of automated control of inspired oxygen (FiO2) by Predictive Intelligent Control of Oxygenation (PRICO) on the Fabian ventilator in maintaining oxygen saturation (SpO2) in preterm infants on high flow nasal cannula (HFNC) support.

DESIGN: Single-centre randomised two-period crossover study.

SETTING: Tertiary neonatal intensive care unit.

PATIENTS: 27 preterm infants (gestational age (GA) <30 weeks) on HFNC support with FiO2 >0.25.

INTERVENTION: A 24-hour period on automated FiO2-control with PRICO compared with a 24-hour period on routine manual control (RMC) to maintain a SpO2 level within target range of 88%-95% measured at 30 s intervals.

MAIN OUTCOME MEASURES: Primary outcome: time spent within target range (88%-95%).

SECONDARY OUTCOMES: time spent above and below target range, in severe hypoxia (SpO2 <80%) and hyperoxia (SpO2 >98%), mean SpO2 and FiO2 and manual FiO2 adjustments.

RESULTS: 15 patients received PRICO-RMC and 12 RMC-PRICO. The mean time within the target range increased with PRICO: 10.8% (95% CI 7.6 to 13.9). There was a decrease in time below target range: 7.6% (95% CI 4.2 to 11.0), above target range: 3.1% (95% CI 2.9 to 6.2) and in severe hypoxia: 0.9% (95% CI 1.5 to 0.2). We found no difference in time spent in severe hyperoxia. Mean FiO2 was higher during PRICO: 0.019 (95% CI 0.006 to 0.030). With PRICO there was a reduction of manual adjustments: 9/24 hours (95% CI 6 to 12).

CONCLUSION: In preterm infants on HFNC support, automated FiO2-control by PRICO is superior to RMC in maintaining SpO2 within target range. Further validation studies with a higher sample frequency and different ventilation modes are needed.

Originele taal-2Engels
Pagina's (van-tot)F621-F626
Aantal pagina's6
TijdschriftArchives of Disease in Childhood : Fetal and Neonatal Edition
Nummer van het tijdschrift6
Vroegere onlinedatum10 mei 2021
StatusGepubliceerd - nov. 2021

Bibliografische nota

© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.


Funding This study was supported by an unrestricted research grant from Chiesi Pharmaceuticals BV, The Netherlands.

Chiesi Farmaceutici


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