Does the duration of oxygen dependence after birth influence subsequent respiratory morbidity?
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Published on: November 2, 2015
F Giffin1, A Greenough, B Yuksel
1Department of Child Health, King's College Hospital, London, UK.
Insights
Oxygen dependency beyond one month in newborns, regardless of bronchopulmonary dysplasia (BPD), significantly increases long-term respiratory issues. This impacts infant respiratory morbidity, highlighting the need for careful oxygen management.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Neonatal chronic lung disease (CLD) encompasses various conditions affecting infant respiratory health.
- Bronchopulmonary dysplasia (BPD) represents a severe form of neonatal CLD.
- Understanding the long-term respiratory impact of different neonatal lung conditions is crucial for patient outcomes.
Purpose of the Study:
- To assess the relationship between neonatal chronic lung disease (Type I CLD and BPD/Type II CLD) and subsequent respiratory morbidity.
- To compare respiratory symptoms and lung function in infants with and without neonatal CLD.
- To determine if oxygen dependency duration influences long-term respiratory outcomes.
Main Methods:
- Comparison of three matched infant groups: Type I CLD (Group A), BPD/Type II CLD (Group B), and no CLD (Group C).
- Prospective follow-up for 3 years, documenting respiratory symptoms.
- Lung function measurement using plethysmography at 1 year of age.
Main Results:
- Groups A and B required significantly longer oxygen therapy durations than Group C.
- Infants in Groups A and B exhibited significantly higher rates of respiratory symptoms over 3 years compared to Group C.
- Elevated airway resistance was observed in Groups A and B compared to Group C, with statistical significance between Groups A and C.
Conclusions:
- Oxygen dependency beyond one month of age is a significant predictor of increased respiratory morbidity in infants.
- This increased morbidity occurs irrespective of the specific diagnosis of BPD, emphasizing the impact of prolonged oxygen use.
- Findings underscore the importance of minimizing prolonged oxygen therapy in neonates to improve long-term respiratory health.
Abstract:
The relationship of respiratory morbidity at follow up to the development and type of "neonatal" chronic lung disease has been assessed. Three groups, each of ten infants matched for gestational age and gender, were compared. Group A had Type I chronic lung disease and group B bronchopulmonary (BPD), the most severe form of neonatal chronic lung disease (Type II CLD); group C had developed neither Type I or Type II CLD. Group B compared to group A compared to group C required a significantly longer duration of oxygen therapy on the neonatal unit. All three groups were prospectively followed; the occurrence of symptoms was documented in each of the first 3 years of life and lung function was measured using a plethysmographic technique at the end of year 1. In all 3 years a significantly greater proportion of groups A and B were symptomatic compared to group C, but there was no significant difference in the proportion so affected between groups A and B. Airway resistance was higher in both groups A and B compared to C but only reached statistical significance on comparing groups A and C. We conclude oxygen dependency beyond 1 month of age, irrespective of the development of BPD, significantly increases respiratory morbidity at follow up.
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