Impact of a protocol-driven unified service for neonates with bronchopulmonary dysplasia

针对患有支气管肺发育不良的新生儿,以方案为导向的统一服务的影响

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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.

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