Faculty Collaboration Database

Varying patterns of home oxygen use in infants at 23-43 weeks' gestation discharged from United States neonatal intensive care units. J Pediatr 2013 Oct;163(4):976-82.e2

Date

06/19/2013

Pubmed ID

23769504

Pubmed Central ID

PMC4027028

DOI

10.1016/j.jpeds.2013.04.067

Scopus ID

2-s2.0-84884672825 (requires institutional sign-in at Scopus site)   38 Citations

Abstract

OBJECTIVES: To compare proportions of infants at different gestational ages discharged from the neonatal intensive care unit (NICU) on home oxygen, to determine how many were classified with chronic lung disease based on timing of discharge on home oxygen, and to determine the percentage discharged on home oxygen who received mechanical ventilation.

STUDY DESIGN: We evaluated a retrospective cohort of infants of 23-43 weeks' gestational age discharged from 228 NICUs in 2009, using the Pediatrix Clinical Data Warehouse. Multilevel logistic regression analysis identified predictors of home oxygen use among extremely preterm, early-moderate preterm, late preterm, and term infants. Duration of mechanical ventilation and median length of stay were calculated for infants discharged on home oxygen.

RESULTS: For the 48877 infants studied, the rate of home oxygen use ranged from 28% (722 of 2621) in extremely preterm infants to 0.7% (246 of 34 934) in late preterm and term infants. Extremely preterm infants composed 56% (722 of 1286) of the infants discharged on home oxygen; late preterm and term infants, 19% (246 of 1286). After gestational age, mechanical ventilation was the main predictor of home oxygen use; however, 61% of the late preterm and term infants discharged on home oxygen did not receive ventilation. The median length of hospital stay was 95 days (IQR, 76-114 days) for extremely preterm infants discharged on home oxygen, but only 15 days (IQR, 10-22 days) for late preterm and term ventilated infants discharged on home oxygen.

CONCLUSION: Although home oxygen use is uncommon in later-gestation infants, the greater overall numbers of later-gestation infants contribute significantly to the increased need for home oxygen for infants at NICU discharge. Neither respiratory failure nor lengthy hospitalization is a prerequisite for home oxygen use at later gestational age.

Author List

Lagatta JM, Clark RH, Brousseau DC, Hoffmann RG, Spitzer AR

Author

Joanne M. Lagatta MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Chronic Disease
Female
Gestational Age
Home Nursing
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases
Intensive Care, Neonatal
Length of Stay
Logistic Models
Lung Diseases
Male
Oxygen
Patient Discharge
Respiration, Artificial
Retrospective Studies
Risk Factors
Time Factors