Does automatic oxygen control help preterm infants breathe less than manual settings?
Preterm infants often need extra oxygen and breathing support. Keeping their oxygen levels in a safe range is tricky. Automatic oxygen control uses a computer to adjust oxygen levels constantly, while manual control relies on nurses or doctors making changes by hand. Research shows that automatic control helps infants spend less time on a breathing machine and need oxygen for fewer days.
What the research says
A 2025 randomized trial in 69 preterm infants found that those on closed-loop automatic oxygen control (CLAC) had a shorter duration of mechanical ventilation (median 11 days vs 40 days) and shorter duration of supplemental oxygen (33 days vs 47 days) compared to manual control 3. They also had less bronchopulmonary dysplasia (55% vs 83.9%) and fewer needed home oxygen 3.
A larger 2026 trial in 32 neonatal units across four countries studied extremely preterm infants (23-27 weeks) and found that automatic control reduced the composite outcome of death, necrotizing enterocolitis, bronchopulmonary dysplasia, or severe retinopathy of prematurity 6. This suggests automatic control improves not just breathing but also overall outcomes.
Earlier studies also support these findings. A 2014 trial showed automatic control increased time in target oxygen range (71.2% vs 61.4%) and reduced manual adjustments 7. A 2004 crossover trial found automatic control achieved similar oxygen stability as a dedicated person manually adjusting oxygen, and better than routine manual care 8.
While one source discussed olfactory stimulation for feeding 1 and another focused on predicting need for mechanical ventilation 2, these do not directly address automatic vs manual oxygen control. Similarly, studies on brain development 4 and intranasal breast milk 5 are not relevant to this question.
What to ask your doctor
- Is automatic oxygen control available in our NICU for my baby?
- What are the potential benefits and risks of automatic vs manual oxygen control for my baby's specific condition?
- How does automatic oxygen control affect the need for breathing support and oxygen therapy?
- Are there any studies or guidelines your hospital follows regarding automatic oxygen control in preterm infants?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.