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Predictors of home oxygen duration in chronic neonatal lung disease
  • +2
  • Matthew Wong,
  • Melissa Neylan,
  • Gordon Williams,
  • Syeda Zahir,
  • Jasneek Chawla
Matthew Wong
Children's Health Queensland Hospital and Health Service
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Melissa Neylan
Queensland Health Centre for Children's Health Research
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Gordon Williams
Children's Health Queensland Hospital and Health Service
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Syeda Zahir
Queensland Health Centre for Children's Health Research
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Jasneek Chawla
Children's Health Queensland Hospital and Health Service
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Abstract

Aims:  In infants with chronic neonatal lung disease (CNLD), we aimed to identify predictors of home oxygen duration, predictors of discharge oxygen flow rates and the association of oxygen flow rates with respiratory outcomes.
Methods:  Retrospective review of infants with CNLD requiring home oxygen in 2016 and 2017.  Hazard ratios (HR) were estimated from Cox proportional hazards regression models in the cohort.  A multinomial logistic regression model examined the effects of maternal and infant variables on discharge oxygen flow rates.  Kruskal-Wallis test with univariate linear regression and Fisher’s exact test with binomial univariate logistic regression were used to examine associations between oxygen flow groups and post-discharge clinical variables.
Results:  149 infants were included.  Median corrected gestational age (CGA) at oxygen cessation was 6.8 months (IQR 4.4) with 87.2% of infants weaned by 12 months CGA.  Shorter initial neonatal intensive care unit (NICU) stay predicted faster oxygen weaning at 9 months (HR 0.99, 95%CI 0.98-1.00, p=0.02) and 12 months (HR 0.99, 95%CI 0.98-1.00, p=0.02).  Infants with hypercarbia at discharge or discharged from NICU at higher CGA had higher odds of requiring ≥200mL/min relative to ≤125 mL/min oxygen.  Infants discharged with >250mL/min oxygen were more likely to have a respiratory related admission before two years chronologic age.
Conclusion:  Shorter initial NICU stay was the best predictor of earlier home oxygen cessation.  At NICU discharge, infants with hypercarbia or a higher CGA may require more home oxygen and experience more respiratory related hospital admission in the first two years of chronological age.

Peer review status:ACCEPTED

20 Sep 2020Submitted to Pediatric Pulmonology
21 Sep 2020Submission Checks Completed
21 Sep 2020Assigned to Editor
22 Sep 2020Reviewer(s) Assigned
14 Oct 2020Review(s) Completed, Editorial Evaluation Pending
22 Oct 2020Editorial Decision: Revise Major
24 Dec 20201st Revision Received
24 Dec 2020Submission Checks Completed
24 Dec 2020Assigned to Editor
24 Dec 2020Reviewer(s) Assigned
24 Dec 2020Review(s) Completed, Editorial Evaluation Pending
24 Dec 2020Editorial Decision: Revise Minor
24 Dec 20202nd Revision Received
26 Dec 2020Submission Checks Completed
26 Dec 2020Assigned to Editor
29 Dec 2020Review(s) Completed, Editorial Evaluation Pending
29 Dec 2020Editorial Decision: Accept