Am J Perinatol 2016; 33(01): 034-039
DOI: 10.1055/s-0035-1555122
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Predicting the Need for Home Oxygen Therapy in Preterm Infants Born Before 28 Weeks' Gestation

Melissa C. Liebowitz
1   Department of Pediatrics, University of California, San Francisco, California
,
Ronald I. Clyman
1   Department of Pediatrics, University of California, San Francisco, California
2   Cardiovascular Research Institute, University of California, San Francisco, California
› Author Affiliations
Further Information

Publication History

30 January 2015

07 May 2015

Publication Date:
17 June 2015 (online)

Abstract

Objective To discover a predictor, that could be used at least 3 to 4 weeks' before discharge, to identify infants who would need home oxygen therapy. We hypothesized that infants requiring a high level of respiratory support at 34 weeks' postmenstrual age (PMA) would require home oxygen.

Study Design Single center retrospective study of 143 infants less than 28 weeks' gestation. We determined when infants weaned from each level of respiratory support (mechanical ventilation, nasal continuous airway pressure [nCPAP] or biphasic positive pressure, nasal cannula flow ≥ 2 L/min, nasal cannula flow < 2 L/min or no respiratory support). Our primary outcome was need for home oxygen.

Result Infants who required nCPAP at 34 weeks' PMA had a 100% positive predictive value for home oxygen therapy.

Conclusion Higher levels of respiratory support at 34 weeks' PMA can predict the need for home oxygen and is useful in preparing patients and families for discharge.

 
  • References

  • 1 Stoll BJ, Hansen NI, Bell EF , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 2010; 126 (3) 443-456
  • 2 Howard-Glenn L. Transition to home: discharge planning for the oxygen-dependent infant with bronchopulmonary dysplasia. J Perinat Neonatal Nurs 1992; 6 (2) 85-94
  • 3 Kersting A, Dorsch M, Wesselmann U , et al. Maternal posttraumatic stress response after the birth of a very low-birth-weight infant. J Psychosom Res 2004; 57 (5) 473-476
  • 4 Zanardo V, Freato F. Home oxygen therapy in infants with bronchopulmonary dysplasia: assessment of parental anxiety. Early Hum Dev 2001; 65 (1) 39-46
  • 5 Lagatta J, Clark R, Spitzer A. Clinical predictors and institutional variation in home oxygen use in preterm infants. J Pediatr 2012; 160 (2) 232-238
  • 6 Lagatta JM, Clark RH, Brousseau DC, Hoffmann RG, Spitzer AR. Varying patterns of home oxygen use in infants at 23-43 weeks' gestation discharged from United States neonatal intensive care units. J Pediatr 2013; 163 (4) 976-82.e2
  • 7 Laughon MM, Langer JC, Bose CL , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants. Am J Respir Crit Care Med 2011; 183 (12) 1715-1722
  • 8 Wickremasinghe AC, Rogers EE, Piecuch RE , et al. Neurodevelopmental outcomes following two different treatment approaches (early ligation and selective ligation) for patent ductus arteriosus. J Pediatr 2012; 161 (6) 1065-1072
  • 9 Lorch SA, Srinivasan L, Escobar GJ. Epidemiology of apnea and bradycardia resolution in premature infants. Pediatrics 2011; 128 (2) e366-e373
  • 10 Darnall RA, Kattwinkel J, Nattie C, Robinson M. Margin of safety for discharge after apnea in preterm infants. Pediatrics 1997; 100 (5) 795-801
  • 11 Walsh MC, Yao Q, Gettner P , et al; National Institute of Child Health and Human Development Neonatal Research Network. Impact of a physiologic definition on bronchopulmonary dysplasia rates. Pediatrics 2004; 114 (5) 1305-1311
  • 12 Dobson NR, Hunt CE. Interinstitutional variability in home care interventions after neonatal intensive care unit discharge. J Pediatr 2012; 160 (2) 187-188
  • 13 Fanaroff AA, Stoll BJ, Wright LL , et al; NICHD Neonatal Research Network. Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol 2007; 196 (2) 147.e1-147.e8
  • 14 Olsen IE, Groveman SA, Lawson ML, Clark RH, Zemel BS. New intrauterine growth curves based on United States data. Pediatrics 2010; 125 (2) e214-e224