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Home oxygen therapy for chronic lung disease in very low-birth-weight infants
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Insights
Home oxygen therapy allows early discharge for infants with chronic lung disease, reducing prolonged hospitalization. Careful follow-up is crucial for their growth and development post-discharge.
Area of Science:
- Neonatal Intensive Care
- Pediatric Pulmonology
Background:
- Chronic lung disease (CLD) affects a significant portion of very low-birth-weight (VLBW) infants.
- Prolonged hospitalization for VLBW infants with CLD requiring oxygen therapy presents challenges.
Purpose of the Study:
- To evaluate the safety and outcomes of home oxygen therapy for VLBW infants with CLD.
- To assess the impact of early discharge with home oxygen on infant rehospitalization and development.
Main Methods:
- A cohort of VLBW infants admitted to a neonatal intensive care unit was studied.
- Infants diagnosed with CLD received supervised home oxygen therapy post-hospitalization.
- Follow-up included assessments of somatic and psychomotor development at one year of corrected age.
Main Results:
- 34% of VLBW survivors developed CLD, with 23 infants undergoing home oxygen therapy.
- The majority (91%) of infants required rehospitalization within the first year.
- Developmental follow-up revealed significant delays in motor development and intellectual disability in several infants.
Conclusions:
- Supervised home oxygen therapy enables safe early discharge for selected VLBW infants with CLD.
- Close monitoring of somatic and psychomotor development is essential for these infants after discharge.
Abstract:
Prolonged hospitalization in infants suffering from chronic lung disease who require continuous oxygen therapy can be avoided by oxygen administration at home. In the period from August 1995 to September 1996, 155 very low-birth-weight (VLBW) infants were consecutively admitted to the neonatal intensive care unit of Mackay Memorial Hospital. Of the 155 infants, 72% (111/155) survived to discharge. However, 34% (38/111) of the survivors developed chronic lung disease. Twenty-three infants with chronic lung disease underwent home oxygen therapy after 107.0 +/- 43.6 days of hospitalization. The mean duration of home oxygen therapy was 4.3 +/- 3.4 months. In the first year after discharge, 91% of the patients required rehospitalization. One patient died during the fourth hospitalization. Follow-up information on growth and development at one year of corrected age was available for 19 patients. Five of the 19 patients had a body weight below the 5th percentile. Five of the 19 infants were mentally retarded and 12 of the 19 patients had significantly delayed motor development. In conclusion, carefully supervised home oxygen therapy permits safe early discharge of selected VLBW infants with chronic lung disease. Their somatic and psychomotor development should be carefully followed up.