Impact of a protocol-driven unified service for neonates with bronchopulmonary dysplasia. Issue 1 (25th March 2019)

• Record Type: Journal Article
• Authors: Batey, Natalie; Batra, Dushyant; Dorling, Jon; Bhatt, Jayesh Mahendra
• Is Part Of: ERJ open research. Volume 5:Issue 1(2019)
• Publication Date: 2019-03-25
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; Respiration; Respiratory organs -- Diseases; Respiratory organs -- Diseases -- Treatment; Respiratory Tract Diseases; Electronic journals; Fulltext; Internet Resources; Periodicals; Periodical; 616.2005
• DOI: 10.1183/23120541.00183-2018
• Languages: English
• ISSNs: 2312-0541

Abstract

Aim: A new specialised service for preterm infants with bronchopulmonary dysplasia requiring long-term oxygen therapy (LTOT) was established in 2007, led by the paediatric respiratory team, transitioning from neonatal-led follow-up. The new service included the utilisation of a clear protocol. Our objective was to review whether this service initiation led to a reduction of time in LTOT and hospital readmissions. Methods: We performed a retrospective cohort study of infants born at <32 weeks' gestation requiring LTOT in a single tertiary neonatal service. Cases were identified from hospital records, BadgerNet and a local database for two cohorts, 2004–2006 and 2008–2010. Data collected for infants requiring LTOT included demographic details, length of neonatal stay, time in oxygen and hospital attendance rates. Results: The initiation of the service led to an increase in the number of discharges in LTOT: 13.1% of infants born alive before 32 weeks' gestation in comparison to 3.5% (p<0.001). However, the length of time in LTOT reduced from 15 to 5 months (p=0.01). There was no difference in hospital readmission rates (p=0.365). Conclusions: In our experience the increase in neonates requiring LTOT is likely to be due to enhanced provision of overnight oximetry studies prior to discharge. Structured monitoring and weaning led to a shorter duration of home oxygen therapy. The implementation of a clear protocol for assessment and management of neonates with bronchopulmonary dysplasia may lead to more infants being discharged in home oxygen, but has potential to reduce overall healthcare costs and improve long-term outcomes http://ow.ly/fYcv30nIc2c