Implementation of Predictive Intelligent Control of Oxygenation (PRICO®) on High Flow Nasal Cannula Support in preterm infants.

In order to avoid hypo- and hyperoxia in preterm infants, oxygen administration is manually controlled by the nurses with use of pulseoximetry. However, with manual control of oxygen administration, oxygen saturations are still 50 time percent above or below the target range. New ventilators are able to automatically adjust oxygen administration guided by pulseoxymetry. Different studies in preterm infants on mechanical ventilation or Continuous Positive Airway Pressure (CPAP), have shown that the use of ventilators with closed loop oxygen administration leads to a significant higher amount of saturations within target range. However, recent ventilators combine the closed-loop technology with High Flow Nasal Cannula (HFNC) support, which resembles CPAP. We aim to study the effect of closed loop oxygenation in preterm infants on HFNC on amount of time spent within saturation target range.

The use of automated closed loop oxygen control in infants on infants with high flow nasal canulla (HFNC) support, will lead to higher amount of saturations within target range compared to manual control.

After birth (Gestational Age<30 weeks) and with FiO2 >0.25, during NICU admission. After parental consent.

In this observational cross-over study we mark two consecutive periods of 24 hours each, in whom oxygen delivery to infant will be controlled by the certified PRICO device or manually by the nurse. The sequence of oxygen control (i.e. manual-FiO2 first or PRICO first) will be determined by randomization, using sequentially numbered opaque sealed envelopes.