New Zealand Leads Medical Breakthrough In Oxygen Therapy | Scoop News – Scoop

Posted: May 25, 2022 at 4:13 am

Wednesday, 25 May 2022, 11:08 amPress Release: Medical Research Institute of New Zealand

Fisher & Paykel Healthcares new Airvo 3 devicewith OptiO2 technology, with support from MedicalResearch Institute of New Zealand, offers a majorbreakthrough in the delivery of oxygen therapy to criticallyill patients.

Landmark clinical research, undertakenby the Medical Research Institute of New Zealand (MRINZ),has shown that automatically measuring and adjusting thedelivery of oxygen (known as titration) to achieve a pre-setlevel of oxygen in the blood of seriously ill patients,results in a far more precise delivery of oxygen than thecurrent standard clinical practice of manualtitration.

Fisher & Paykel Healthcare applied thisresearch in the development of its new Airvo 3 device,progressed through an ongoing partnership with researchteams at MRINZ. Designed to deliver Optiflow therapy, thedevice incorporates Fisher & Paykel HealthcaresOptiO2 closed-loop system for targeted oxygen delivery. Acontrolled market release of the Airvo 3 with OptiO2technology is now underway in Aotearoa New Zealand, and itwill be available in other markets as regulatory clearancesare received.

The Automatic versus manual oxygentitration using a novel nasal high-flow device in medicalinpatients with an acute illness study, published in theBritish Medical Journal Open Respiratory Research in2021, represents the latest in alongstanding programme of work at the MRINZ which hasdetermined how best to administer oxygentherapy.

MRINZ has assessed both the risk and benefitsof different oxygen regimens in a wide range of acute andchronic medical conditions through a series of randomisedcontrolled trials, and used this knowledge to guide clinicalpractice.

Earlier trial outcomes showing that both toomuch and too little prescribed oxygen has potential riskswas crucial in the development of international guidelinesfor adopting the swimming between the flags oxygendelivery framework. Swimming between the flags is atreatment concept promoted by respiratory specialistProfessor Richard Beasley, Director of the MRINZ. Thisconcept, now used worldwide, simplifies how cliniciansadminister oxygen therapy to critically ill patients, givingpatients as much or little oxygen as needed to keep theirblood oxygen saturation within a prescribed targetrange.

In current clinical practice healthprofessionals attempt to achieve a pre-set target of bloodoxygen levels by measuring oxygen saturations with a pulseoximeter, a small device clipped to a patients finger,and then manually varying the amount of oxygen administeredin an attempt to achieve the target oxygen saturation range.This practice can be inadequate, because even with closemonitoring patients may be below or above the target rangefor prolonged periods of time.

To overcome thisproblem, Fisher & Paykel Healthcare have enhanced theAirvo 3 device, allowing humidified oxygen to beautomatically titrated in response to changes in oxygensaturation, as measured from the pulse oximeter linked tothe Airvo system.

Professor Richard Beasley, MRINZDirector, says, Fisher & Paykel Healthcares Airvo3 is likely to result in a paradigm change in the way oxygenis delivered to critically ill patients here in Aotearoa NewZealand, and eventually, globally. With this new devicethere is now the capability to titrate the amount of oxygendelivered via nasal high flow therapy, which may help toensure that the patient can safely swim between theflags.

Oxygen is a common treatment in patientswho are admitted to hospital acutely unwell. This latestMRINZ clinical research, sponsored by Fisher & PaykelHealthcare, studied acutely unwell patients admitted toWellington Regional Hospital. The patients had a wide rangeof medical conditions including heart failure, pneumonia,pulmonary embolism and exacerbations of asthma and chronicobstructive pulmonary disease (COPD).

The study foundthat automatic oxygen titration resulted in 96% of the timespent within the target saturation range, compared with 71%with manual titration.

Dr James Harper, leadresearcher in the study, says, These findings are reallyimportant, as they show that use of this new device ensuresthat unwell patients spend almost all the time preciselywithin the optimum target saturation range, avoiding therisk of both too much and too little oxygen.

Aswe know that maintaining oxygen saturations withinprescribed target ranges leads to improved clinicaloutcomes, the use of this device is likely to help manypatients who need oxygen in hospital, says DrHarper.

Garry Middleton Simpson is one of the twentypatients who took part in the study. As a patient youtake for granted that the oxygen that is administrated toyou is being delivered the best possible way. I amincredibly grateful that the researchers at MRINZ and theteam at Fisher & Paykel Healthcare are so curious anddedicated, questioning clinical methods, and finding new andbetter ways to care for sick people when they need itmost, says Garry.

Quality medical care increasinglyrelies on innovative new technologies, and the MRINZcollaboration with Fisher & Paykel Healthcare representsa significant and valued partnership. The MRINZ worksclosely with the biomedical industry to design and conductgold-standard research supporting device development andadoption in practice.

Medical devices and advancedtechnologies greatly help clinicians deliver the bestpossible patient care. Supporting product innovation anddevelopment is a significant part of our MRINZ focus. Itsa privilege to work in collaboration with Fisher &Paykel Healthcares world-leading designers and engineersto develop and test novel devices that have the potential tochange clinical practice, says Adjunct Professor AlexSemprini, MRINZ Deputy Director.

Andrew Somervell, VP Products and Technology at Fisher & PaykelHealthcare, says, Our teams worked closely with ourcustomers and clinicians to design a device that meetshealthcare providers evolving needs and delivers betterpatient outcomes. We value our longstanding relationshipwith MRINZ and are grateful for their support on theresearch and development of the Airvo3.



Automaticversus manual oxygen titration using a novel nasal high-flowdevice in medical inpatients with an acute illness:

Currentguideline recommendations state oxygen should beadministered to acutely unwell patients to achieve a targetoxygen saturation (SpO2) range. The current practice ofmanual oxygen titration frequently results in SpO2 outsideof a prescribed range. The aim of this study was to assessthe efficacy of automatic oxygen titration using aclosed-loop feedback system to achieve SpO2 within aprescribed target range.

An open-label randomisedparallel group trial was undertaken comparing automaticoxygen titration using a novel nasal high-flow device tomanual oxygen titration using nasal high flow. Medicalinpatients requiring oxygen therapy in Wellington RegionalHospital, New Zealand with a prescribed target SpO2 range of88%-92% or 92%-96% were recruited and randomised equallybetween the interventions for a period of 24 hours. Theprimary outcome was the proportion of time spent with SpO2within the prescribed range.

Twenty patients wereincluded in the analysis. Automatic oxygen titrationresulted in a median (IQR) 96.2% (95.2-97.8) of time withinthe target range compared with 71% (59.4-88.3) with manualtitration; difference (95% CI) 24.2% (7.9% to 35%),p

The conclusion of the study is thatnasal high-flow with automatic oxygen titration resulted ina greater proportion of time spent with SpO2 in target rangecompared with manualtitration.

Medical ResearchInstitute of New ZealandRangahautia TeOra

The Medical Research Institute of New Zealand(MRINZ) is Aotearoa New Zealands leading independentmedical research institute. MRINZ research is guided by asimple philosophy: it must challenge dogma, increaseknowledge, and have the potential to improve clinicalpractice and outcomes, both in Aotearoa New Zealand, andinternationally.

The MRINZs research teams arededicated to investigating important public health problems,delivering high quality evidence on which to improve themanagement of disease and patient care. An internationallyrecognised academic institution, the MRINZ is a charitabletrust pursuing advances in clinical practice and providing abase for specialist training in medical research. The MRINZis committed to contributing toward a more equitable societythat celebrates Te Ao Mori and upholds Te Tiriti oWaitangi.

Fisher & PaykelHealthcare

Fisher & Paykel Healthcare isa leading designer, manufacturer and marketer of productsand systems for use in acute and chronic respiratory care,surgery and the treatment of obstructive sleep apnea. Thecompanys products are sold in over 120 countriesworldwide. For more information, visit

DrJames Harper, MRINZ Clinical Research Fellow andAlumniJames completed his undergraduate medicaltraining at the University of Bristol, England and graduatedwith honours in 2009. He subsequently completed hispostgraduate medical training in the South-West of England,specialising in Respiratory Medicine. James undertook a PhDduring his specialist Respiratory training at the MedicalResearch Institute of New Zealand during which time heinvestigated a novel method of oxygen delivery involvingnasal high-flow with automatic oxygen titration. He wassuccessfully awarded a PhD from Victoria University ofWellington in 2021 and subsequently returned to the UK tocomplete his specialist training. James has recently beenappointed a Consultant in Respiratory Physician at the RoyalUnited Hospital, Bath. James has an ongoing interest inresearch and oxygen delivery for unwellpatients.

Professor Richard Beasley,MRINZ DirectorRichard Beasley, MBChB, MD, DSc,CNZM, is a physician at Wellington Regional Hospital,Director of the Medical Research Institute of New Zealand,and Professor of Medicine at Victoria University ofWellington. He is an Adjunct Professor at the University ofOtago and Visiting Professor, University of Southampton,United Kingdom. He was previously the Deputy Chair of theHealth Research Council of New Zealand. Richards areas ofexpertise and medical interest include Asthma, ChronicObstructive Pulmonary Disease, Epidemiology, Oxygen andRespiratory Medicine.

Professor Beasley is availablefor interview.


Nicola Marshall, MRINZ 2564737

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New Zealand Leads Medical Breakthrough In Oxygen Therapy | Scoop News - Scoop

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