{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:57:54Z","timestamp":1791824274535,"version":"4.3.4"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018936","name":"Universit\u00e4tsklinikum Heidelberg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018936","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this study was to analyze signal loss (SL) resulting from low signal quality of pulse oximetry-derived hemoglobin oxygen saturation (SpO<jats:sub>2<\/jats:sub>) measurements during prolonged hypoxemic episodes (pHE) in very preterm infants receiving automatic oxygen control (AOC). We did a post hoc analysis of a randomized crossover study of AOC, programmed to set FiO<jats:sub>2<\/jats:sub> to \u201cback-up FiO<jats:sub>2<\/jats:sub>\u201d during SL. In 24 preterm infants (median (interquartile range)) gestational age 25.3 (24.6 to 25.6) weeks, recording time 12.7\u00a0h (12.2 to 13.6\u00a0h) per infant, we identified 76 pHEs (median duration 119\u00a0s (86 to 180\u00a0s)). In 50 (66%) pHEs, SL occurred for a median duration of 51\u00a0s (33 to 85\u00a0s) and at a median frequency of 2 (1 to 2) SL-periods per pHE. SpO<jats:sub>2<\/jats:sub> before and after SL was similar (82% (76 to 88%) vs 82% (76 to 87%), <jats:italic>p<\/jats:italic>\u2009=\u20090.3)).<\/jats:p><jats:p><jats:italic>\u00a0 Conclusion<\/jats:italic>: SL is common during pHE and must hence be considered in AOC-algorithm designs. Administering a \u201cbackup FiO<jats:sub>2<\/jats:sub>\u201d (which reflects FiO<jats:sub>2<\/jats:sub>-requirements during normoxemia) during SL may prolong pHE with SL.<\/jats:p><jats:p><jats:italic>\u00a0 Trial registration<\/jats:italic>: The study was registered at <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">www.clinicaltrials.gov<\/jats:ext-link> under the registration no. NCT03785899.\n<jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is Known:<\/jats:bold><jats:italic>\u2022 Previous studies examined SpO2 signal loss (SL) during routine manual oxygen control being rare, but pronounced in lower SpO2 states.<\/jats:italic><jats:italic>\u2022 Oxygen titration during SL is unlikely to be beneficial as SpO2 may recover to a normoxic range.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is New:<\/jats:bold><jats:italic>\u2022 Periods of low signal quality of SpO2 are common during pHEs\u00a0and while supported with automated oxygen control (SPOC), FiO2 is set to a back-up value reflecting FiO2 requirements during normoxemia in response to SL, although SpO2 remained below target until signal recovery.<\/jats:italic><jats:italic>\u2022 FiO2 overshoots following pHEs were rare during AOC and occurred with a delayed onset; therefore, increased FiO2 during SL does not necessarily lead to overshoots.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-024-05549-9","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T15:02:04Z","timestamp":1712674924000},"page":"2865-2869","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pulse oximetry signal loss during hypoxic episodes in preterm infants receiving automated oxygen control"],"prefix":"10.1007","volume":"183","author":[{"given":"Lukas O.","family":"Langanky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7561-3050","authenticated-orcid":false,"given":"Karen B.","family":"Kreutzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1072-0066","authenticated-orcid":false,"given":"Christian F.","family":"Poets","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5066-0857","authenticated-orcid":false,"given":"Axel R.","family":"Franz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0975-1575","authenticated-orcid":false,"given":"Christoph E.","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,9]]},"reference":[{"issue":"4","key":"5549_CR1","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1136\/archdischild-2021-322096","volume":"107","author":"CE Schwarz","year":"2022","unstructured":"Schwarz CE, Kreutzer KB, Langanky L, Wolf NS, Braun W, O\u2019Sullivan MP et al (2022) Randomised crossover trial comparing algorithms and averaging times for automatic oxygen control in preterm infants. 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A.R. Franz and C.F. Poets are supported by a grant from the German Ministry of Research and Education for conducting the FiO<sub>2<\/sub> Controller study on medium-term effects of closed-loop automated control of FiO<sub>2<\/sub>. C.E. Schwarz, A.R. Franz, and C.F. Poets also received a research grant from L\u00f6wenstein Medical, Bad Ems, Germany. C.F. Poets received speaker honoraria from Masimo Inc. The other authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}