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Objectives
To compare proportions of infants at different
gestational a
ges dischar
ged from the neonatal intensive care unit (NICU) on home oxy
gen, to determine how many were classified with chronic lun
g disease based on timin
g of dischar
ge on home oxy
gen, and to determine the percenta
ge dischar
ged on home oxy
gen 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 48?877 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.