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First year morbidity among infants discharged home in oxygen

Presented at the Neonatal Society 2002 Summer Meeting (programme).

Beresford MW, Harrison G*, Shaw NJ

Liverpool Womenís and *Alder Hey Childrenís Hospitals, Liverpool, UK

Background: Chronic lung disease of prematurity (CLD) is associated with significant long-term respiratory morbidity (1). Infants particularly vulnerable are those discharged home in oxygen.

Aims: To assess respiratory morbidity during one-year follow-up of CLD infants discharged home on oxygen therapy.

Methods: Pre-discharge oxygen requirements were set on clinical grounds. Before discharge, oxygen saturations were recorded (blind to clinicians) for four-hours. A home-oxygen nurse specialist prospectively collated infantís oxygen requirements, hospital admissions and attendances, and details of acute life threatening events (ALTEs), over the first twelve months following discharge.

Results: Sixteen infants were studied. Median (range): gestational age was 28 weeks (24-32); birth-weight was 938 grams (448-1,638); discharge oxygen requirement was 0.20 litres/minute (0.05-0.50) via nasal cannulae; duration of oxygen requirement (up to 12 months corrected age) was 310 days (83-462). One infant died, seven required admission for respiratory causes on 3 occasions (2-5) for a total of 13 days (7-117).

Eight infants had ALTEs on 2 occasions (1-5). Their discharge oxygen saturation profiles were significantly lower when compared to those not having ALTEs (p<0.05), despite being on oxygen therapy. The graph shows the median and lower 5th centile for cumulative percentage oxygen saturation for the two groups.

Conclusions: Before discharge home, oxygen saturation profiles should performed on all infants to ensure optimum oxygen delivery

1. Bhutani VK. Clin Perinatol 1992;19:649-671

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