Publications by authors named "Ingo Müller-Hansen"

3 Publications

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In vitro evaluation of delays in the adjustment of the fraction of inspired oxygen during CPAP: effect of flow and volume.

Arch Dis Child Fetal Neonatal Ed 2021 Mar 12;106(2):205-207. Epub 2020 Aug 12.

Department of Neonatology, University Children's Hospital, Tübingen, Germany.

Background: Adjusting the fraction of inspired oxygen (FiO) delivered to preterm infants to keep their oxygen saturation within target range remains challenging. Closed-loop automated FiO control increases the time infants spend within the assigned target range. The delay with which FiO adjustments at the ventilator result in a change in the inspired gas limits the performance of both manual and automated controls.

Objective: To evaluate the equilibration time (T) between FiO adjustments and changes in FiO reaching the patient.

Methods: In vitro determination of the delay in FiO adjustments at the ventilator at 5 and 8 L/min of gas flow and two different humidifier/ventilator circuit volumes (840 and 432 mL).

Results: T values were 31, 23, 20 and 17 s for the volume-flow combinations 840 mL+5 L/min, 840 mL+8 L/min, 432 mL+5 L/min and 432 mL+8 L/min, respectively.

Conclusion: The identified delay seems clinically relevant and should be taken into account during manual and automatic control of FiO.
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http://dx.doi.org/10.1136/archdischild-2020-319058DOI Listing
March 2021

Automatic control of the inspired oxygen fraction in preterm infants: a randomized crossover trial.

Am J Respir Crit Care Med 2004 Nov 3;170(10):1095-100. Epub 2004 Sep 3.

Department of Neonatology, Tuebingen University Hospital, Tuebingen, Germany.

In preterm infants receiving supplemental oxygen, manual control of the inspired oxygen fraction is often time-consuming and inappropriate. We developed a system for automatic oxygen control and hypothesized that this system is more effective than routine manual oxygen control in maintaining target arterial oxygen saturation levels. We performed a randomized controlled crossover clinical trial in 12 preterm infants receiving nasal continuous positive airway pressure and supplemental oxygen. Periods with automatic and routine manual oxygen control were compared with periods of optimal control by a fully dedicated person. The median (range) percentage of time with arterial oxygen saturation levels within target range (87-96%) was 81.7% (39.0-99.8) for routine manual oxygen control, 91.0% (41.4-99.3) for optimal control, and 90.5% (59.0-99.4) for automatic control (ANOVA: p = 0.01). Pairwise post hoc comparisons revealed a statistically significant difference between automatic and routine manual oxygen control (Dunnett's test: p = 0.02). The frequency of manual oxygen adjustments was lowest in automatic control (Friedman's test: p < 0.001). Automatic oxygen control may optimize oxygen administration to preterm infants receiving nasal continuous positive airway pressure and reduce nursing time spent with oxygen control.
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http://dx.doi.org/10.1164/rccm.200407-929OCDOI Listing
November 2004

Early treatment with erythropoietin beta ameliorates anemia and reduces transfusion requirements in infants with birth weights below 1000 g.

J Pediatr 2002 Jul;141(1):8-15

Objective: To investigate whether recombinant erythropoietin (rhEPO) reduces the need for transfusion in extremely low birth weight (ELBW) infants (birth weight 500-999 g) and to determine the optimal time for treatment.

Methods: In a blinded multicenter trial, 219 ELBW infants were randomized on day 3 to one of 3 groups: early rhEPO group (rhEPO from the first week for 9 weeks, n = 74), late rhEPO group (rhEPO from the fourth week for 6 weeks, n = 74), or control group (no rhEPO, n = 71). All infants received enteral iron (3-9 mg/kg/day) from the first week. The rhEPO beta dose was 750 IU/kg/week. Success was defined as no transfusion and hematocrit levels never below 30%.

Results: Success rate was 13% in the early rhEPO group, 11% in the late rhEPO group, and 4% in the control group (P =.026 for early rhEPO versus control group). Median transfusion volume was 0.4 versus 0.5 versus 0.7 mL/kg/day (P =.02) and median donor exposure was 1.0 versus 1.0 versus 2.0 (P =.05) in the early rhEPO group, the late rhEPO group, and the control group, respectively. Infection risk was not increased and weight gain was not delayed with rhEPO beta.

Conclusion: Early rhEPO beta treatment effectively reduces the need for transfusion in ELBW infants.
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http://dx.doi.org/10.1067/mpd.2002.124309DOI Listing
July 2002