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Controversy Surrounding the Use of Home Oxygen for Premature Infants with Bronchopulmonary Dysplasia

Journal of Perinatology volume 24, pages 36–40 (2004)Cite this article

Abstract

OBJECTIVE: To determine the criteria used in the current practice of neonatology for the initiation of home oxygen therapy in premature infants with bronchopulmonary dysplasia and to compare these criteria with the available literature regarding the use of home oxygen therapy.

STUDY DESIGN: Participants in the December 2000 meeting of the Vermont Oxford Network were surveyed regarding their current use of home oxygen therapy for infants with bronchopulmonary dysplasia.

RESULTS: Surveys were returned by 181 out of 297 participants. Pulse oximetry saturation (SpO2) thresholds for the initiation of home oxygen therapy varied widely from <84% to <98%. The most common threshold was <90% chosen by only 43% of the respondents. Additionally, 22% of the respondents did not initiate therapy until the oxygen saturation in room air was below 88%. Once on oxygen therapy, the target SpO2 also varied widely from >84% to >98%, with only 27% of respondents aiming for an SpO2 of >94%.

CONCLUSIONS: There is a clear lack of consensus among neonatologists regarding the initiation of home oxygen therapy for bronchopulmonary dysplasia. Furthermore, the criteria used for home oxygen therapy varies widely with the majority of neonatologists surveyed using oxygen saturation levels not supported by the literature. We speculate that a significant underutilization of home oxygen therapy exists for infants with bronchopulmonary dysplasia.

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References

  1. Peter C, Poets CF . Prescription of home oxygen therapy to infants in Germany. Biol Neonate 2001;80:148–151.

    Article  CAS  PubMed  Google Scholar 

  2. Solis A, Harrison G, Shaw BN . Assessing oxygen requirement after discharge in chronic lung disease: a survey of current practice. Eur J Pediatr 2002;161:428–430.

    Article  PubMed  Google Scholar 

  3. Ellsbury DL, Acarregui MJ, McGuinness GA, Klein JM . Variability in the use of supplemental oxygen for bronchopulmonary dysplasia. J Pediatr 2002;140:247–249.

    Article  PubMed  Google Scholar 

  4. Hunt CE, Corwin MJ, Lister G, et al. Longitudinal assessment of hemoglobin oxygen saturation in healthy infants during the first 6 months of age. Collaborative Home Infant Monitoring Evaluation (CHIME) Study Group. J Pediatr 1999;135:580–586.

    Article  CAS  PubMed  Google Scholar 

  5. Poets CF, Stebbens VA, Alexander JR, Arrowsmith WA, Salfield SA, Southall DP . Arterial oxygen saturation in preterm infants at discharge from the hospital and six weeks later. J Pediatr 1992;120:447–454.

    Article  CAS  PubMed  Google Scholar 

  6. Richard D, Poets CF, Neale S, Stebbens VA, Alexander JR, Southall DP . Arterial oxygen saturation in preterm neonates without respiratory failure. J Pediatr 1993;123:963–968.

    Article  CAS  PubMed  Google Scholar 

  7. Ng A, Subhedar N, Primhak RA, Shaw NJ . Arterial oxygen saturation profiles in healthy preterm infants. Arch Dise Child Fetal Neonatal Ed 1998;79:F64–F66.

    Article  CAS  Google Scholar 

  8. Thilo EH, Andersen D, Wasserstein ML, Schmidt J, Luckey D . Saturation by pulse oximetry: comparison of the results obtained by instruments of different brands. J Pediatr 1993;122:620–626.

    Article  CAS  PubMed  Google Scholar 

  9. Groothuis JR, Rosenberg AA . Home oxygen promotes weight gain in infants with bronchopulmonary dysplasia. Am J Dis Child 1987;141:992–995.

    CAS  PubMed  Google Scholar 

  10. Hudak BB, Allen MC, Hudak ML, Loughlin GM . Home oxygen therapy for chronic lung disease in extremely low-birth-weight infants. Am J Dis Child 1989;143:357–360.

    CAS  PubMed  Google Scholar 

  11. Moyer-Mileur LJ, Nielson DW, Pfeffer KD, Witte MK, Chapman DL . Eliminating sleep-associated hypoxemia improves growth in infants with bronchopulmonary dysplasia. Pediatrics 1996;98:779–783.

    CAS  PubMed  Google Scholar 

  12. Tay-Uyboco JS, Kwiatkowski K, Cates DB, Kavanagh L, Rigatto H . Hypoxic airway constriction in infants of very low birth weight recovering from moderate to severe bronchopulmonary dysplasia. J Pediatr 1989;115:456–459.

    Article  CAS  PubMed  Google Scholar 

  13. Abman SH, Wolfe RR, Accurso FJ, Koops BL, Bowman CM, Wiggins Jr JW . Pulmonary vascular response to oxygen in infants with severe bronchopulmonary dysplasia. Pediatrics 1985;75:80–84.

    CAS  PubMed  Google Scholar 

  14. McEvoy C, Durand M, Hewlett V . Episodes of spontaneous desaturations in infants with chronic lung disease at two different levels of oxygenation. Pediatr Pulmonol 1993;15:140–144.

    Article  CAS  PubMed  Google Scholar 

  15. Werthammer J, Brown ER, Neff RK, Taeusch Jr HW . Sudden infant death syndrome in infants with bronchopulmonary dysplasia. Pediatrics 1982;69:301–304.

    CAS  PubMed  Google Scholar 

  16. Gray PH, Rogers Y . Are infants with bronchopulmonary dysplasia at risk for sudden infant death syndrome? Pediatrics 1994;93:774–777.

    CAS  PubMed  Google Scholar 

  17. Poets CF . When do infants need additional inspired oxygen? A review of the current literature. Pediatr Pulmonol 1998;26:424–428.

    Article  CAS  PubMed  Google Scholar 

  18. Kotecha S, Allen J . Oxygen therapy for infants with chronic lung disease. Arch Dise Child Fetal Neonatal Ed 2002;87:F11–F14.

    Article  CAS  Google Scholar 

  19. Abman SH . Monitoring cardiovascular function in infants with chronic lung disease of prematurity. Arch Dise Child Fetal Neonatal Ed 2002;87:F15–F18.

    Article  CAS  Google Scholar 

  20. Panitch H . Bronchopulmonary dysplasia. In: McConnell MS, Imaizumi SO (eds), Guidelines for Pediatric Home Health Care. American Academy of Pediatrics; 2002. p. 323–342.

    Google Scholar 

  21. Allen J, Zwerdling R, Ehrenkrantz R, et al. Statement on the care of the child with chronic lung disease of infancy and childhood. Am J Respir Crit Care Med 2003;168:356–396.

    Article  PubMed  Google Scholar 

  22. Avery ME, Tooley WH, Keller JB, et al. Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. Pediatrics 1987;79:26–30.

    CAS  PubMed  Google Scholar 

  23. Thilo EH, Comito J, McCulliss D . Home oxygen therapy in the newborn. Costs and parental acceptance. Am J Dis Child 1987;141:766–768.

    Article  CAS  PubMed  Google Scholar 

  24. McAleese KA, Knapp MA, Rhodes TT . Financial and emotional cost of bronchopulmonary dysplasia. Clin Pediatr (Phila) 1993;32:393–400.

    Article  CAS  Google Scholar 

  25. McLean A, Townsend A, Clark J, et al. Quality of life of mothers and families caring for preterm infants requiring home oxygen therapy: a brief report. J Paediatr Child Health 2000;36:440–444.

    Article  CAS  PubMed  Google Scholar 

  26. Silva DT, Hagan RPDS . Home oxygen management of neonatal chronic lung disease in Western Australia. J Paediatr Child Health 1995;31:185–188.

    Article  CAS  PubMed  Google Scholar 

  27. Zanardo V, Freato F . Home oxygen therapy in infants with bronchopulmonary dysplasia: assessment of parental anxiety. Early Hum Dev 2001;65:39–46.

    Article  CAS  PubMed  Google Scholar 

  28. Tin W, Milligan DWA, Pennfeather P, Hey E . Pulse oximetry, severe retinopathy, and outcome at one year ni babies of less than 28 weeks gestation. Arch Dise Child Fetal Neonatal Ed 2001;84:F106–F110.

    Article  CAS  Google Scholar 

  29. The STOP-ROP Multicenter Study Group. Supplemental therapeutic oxygen for prethreshold retinopathy of prematurity (STOP-ROP), a randomized, controlled trial. I: primary outcomes. Pediatrics 2000;105:295–310.

  30. Finer NN, Bates R, Tomat P . Low flow oxygen delivery via nasal cannula to neonates. Pediatr Pulmonol 1996;21:48–51.

    Article  CAS  PubMed  Google Scholar 

  31. Askie L, Henderson-Smart D, Irwig L, Simpson JM . The effect of differing oxygen saturation targeting ranges on long term growth and development of extremely preterm, oxygen dependent infants: the BOOST trial. Pediatr Res 2002;51:378A.

    Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Children's Hospital of Iowa, University of Iowa, Iowa City, IA, USA

    Dan L Ellsbury MD, Michael J Acarregui MD, Gail A McGuinness MD, Diane L Eastman RN & Jonathan M Klein MD

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  1. Dan L Ellsbury MD
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  2. Michael J Acarregui MD
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  3. Gail A McGuinness MD
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  4. Diane L Eastman RN
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  5. Jonathan M Klein MD
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Ellsbury, D., Acarregui, M., McGuinness, G. et al. Controversy Surrounding the Use of Home Oxygen for Premature Infants with Bronchopulmonary Dysplasia. J Perinatol 24, 36–40 (2004). https://doi.org/10.1038/sj.jp.7211012

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