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Impact of a protocol-driven unified service for neonates with bronchopulmonary dysplasia

Natalie Batey1, Dushyant Batra1, Jon Dorling1,2

  • 1Nottingham Neonatal Service, Nottingham University Hospitals NHS Trust, Nottingham, UK.

ERJ Open Research
|March 29, 2019
PubMed

Insights

A new specialized service reduced the duration of long-term oxygen therapy (LTOT) for preterm infants with bronchopulmonary dysplasia. While more infants were discharged on LTOT, their time on oxygen significantly decreased, with no change in readmissions.

Area of Science:

  • Neonatology
  • Pediatric Respiratory Medicine
  • Public Health

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease in preterm infants.
  • Long-term oxygen therapy (LTOT) is often required for infants with BPD.
  • Transitioning care from neonatal to specialized pediatric respiratory teams can impact outcomes.

Purpose of the Study:

  • To evaluate the impact of a new specialized service on LTOT duration and hospital readmissions in preterm infants with BPD.
  • To assess the effectiveness of a structured protocol in managing LTOT.

Main Methods:

  • Retrospective cohort study comparing infants born before 32 weeks' gestation requiring LTOT.
  • Two cohorts were analyzed: 2004-2006 (pre-service) and 2008-2010 (post-service initiation).
  • Data included demographics, neonatal stay, time in oxygen, and hospital readmission rates.

Main Results:

  • The specialized service saw an increase in discharges with LTOT (13.1% vs 3.5%, p<0.001).
  • The duration of LTOT significantly decreased from 15 to 5 months (p=0.01).
  • Hospital readmission rates showed no significant difference between the cohorts (p=0.365).

Conclusions:

  • Enhanced overnight oximetry and structured monitoring/weaning protocols likely contributed to reduced LTOT duration.
  • The specialized service effectively shortened the time preterm infants with BPD spent on home oxygen.
  • Further research into optimizing discharge criteria and follow-up for these infants is warranted.
Abstract

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