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Experience with home oxygen in the management of infants with bronchopulmonary dysplasia
Insights
Infants with bronchopulmonary dysplasia (BPD) on home oxygen therapy show improved oxygenation but experience poor growth and frequent hospitalizations. Most infants were weaned off oxygen by 12 months corrected age.
Area of Science:
- Pediatrics
- Neonatology
- Pulmonology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in infants.
- Home oxygen therapy is common for infants with BPD.
- Long-term outcomes regarding growth and oxygenation require further study.
Purpose of the Study:
- To monitor growth patterns in infants with BPD on home oxygen.
- To assess the need for hospital readmission in this population.
- To evaluate oxygenation improvement during the first year of life.
Main Methods:
- Followed 23 infants with BPD on home oxygen therapy for one year.
- Assessed oxygenation using serial transcutaneous PO2 (tcPO2) measurements.
- Monitored weight gain and hospital readmissions.
Main Results:
- Poor weight gain observed; boys below 5th percentile, girls at 10th.
- 43% of infants required rehospitalization; no deaths occurred.
- 61% were weaned off oxygen by 12 months corrected age (mean 7.9 months).
- Mean tcPO2 improved by 3 torr/month with significant individual variation.
- Infants off oxygen showed significantly greater growth rates (p<0.02).
- Right ventricular hypertrophy (RVH) tended to resolve during therapy.
Conclusions:
- Infants with BPD on home oxygen generally improve oxygenation steadily.
- Poor growth and frequent hospitalizations are significant challenges.
- Growth is significantly better in infants weaned off oxygen by 12 months.
Abstract:
We followed the clinical course of 23 infants with bronchopulmonary dysplasia (BPD) on home oxygen therapy during the first year of life in order to monitor patterns of growth, need for hospital readmission, and improvement in oxygenation. Oxygenation was assessed by serial, resting, awake, and room air transcutaneous PO2 (tcPO2) measurements at clinic visits. Weight gain was poor, with boys growing below the fifth percentile and girls growing at the tenth percentile. Ten of the 23 infants (43%) required rehospitalizations. There were no deaths. Fourteen of the 23 infants (61%) were taken off supplemental oxygen by 12 months corrected age, at a mean age of 7.9 months. Mean rate of improvement in tcPO2 was 3 torr/month, but wide individual variation was found. Infants off of oxygen treatment at 12 months corrected age grew at a significantly greater rate than those still requiring oxygen supplementation (p less than 0.02). Infants with right ventricular hypertrophy (RVH) by electrocardiogram tended to resolve their RVH while on home oxygen therapy. We conclude that infants with BPD on home oxygen therapy generally show steady improvement in oxygenation, but grow poorly and require frequent hospitalizations.