Closed-loop oxygen control for critically ill patients-A systematic review and metaanalysis
Issued Date
2024-06-01
Resource Type
eISSN
19326203
Scopus ID
2-s2.0-85195782335
Journal Title
PLoS ONE
Volume
19
Issue
6 June
Rights Holder(s)
SCOPUS
Bibliographic Citation
PLoS ONE Vol.19 No.6 June (2024)
Suggested Citation
Mól C.G., da Silva Vieira A.G., Garcia B.M.S.P., dos Santos Pereira E., Eid R.A.C., Schultz M.J., Pinto A.C.P.N., Nawa R.K. Closed-loop oxygen control for critically ill patients-A systematic review and metaanalysis. PLoS ONE Vol.19 No.6 June (2024). doi:10.1371/journal.pone.0304745 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98863
Title
Closed-loop oxygen control for critically ill patients-A systematic review and metaanalysis
Corresponding Author(s)
Other Contributor(s)
Abstract
Background The impact of closed-loop control systems to titrate oxygen flow in critically ill patients, including their effectiveness, efficacy, workload and safety, remains unclear. This systematic review investigated the utilization of closed-loop oxygen systems for critically ill patients in comparison to manual oxygen titration systems focusing on these topics. Methods and findings A search was conducted across several databases including MEDLINE, CENTRAL, EMBASE, LILACS, CINAHL, LOVE, ClinicalTrials.gov, and the World Health Organization on March 3, 2022, with subsequent updates made on June 27, 2023. Evidence databases were searched for randomized clinical parallel or crossover studies investigating closedloop oxygen control systems for critically ill patients. This systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. The analysis was conducted using Review Manager software, adopting the mean difference or standardized mean difference with a 95% confidence interval (95% CI) for continuous variables or risk ratio with 95% CI for dichotomous outcomes. The main outcome of interest was the percentage of time spent in the peripheral arterial oxygen saturation target. Secondary outcomes included time for supplemental oxygen weaning, length of stay, mortality, costs, adverse events, and workload of healthcare professional. A total of 37 records from 21 studies were included in this review with a total of 1,577 participants. Compared with manual oxygen titration, closed-loop oxygen control systems increased the percentage of time in the prescribed SpO2 target, mean difference (MD) 25.47; 95% CI 19.7, 30.0], with moderate certainty of evidence. Current evidence also shows that closed-loop oxygen control systems have the potential to reduce the percentage of time with hypoxemia (MD -0.98; 95% CI -1.68, -0.27) and healthcare workload (MD -4.94; 95% CI -7.28, -2.61) with low certainty of evidence. Conclusion Closed-loop oxygen control systems increase the percentage of time in the preferred SpO2 targets and may reduce healthcare workload.