HOME OXYGEN-THERAPY IN INFANTS WITH BRONCHOPULMONARY DYSPLASIA - A PROSPECTIVE-STUDY

We followed the clinical course of 21 infants with bronchopulmonary dy splasia enrolled in a prospective home O-2 therapy programme during a 4-year-period. Mean gestational age was 28.5 weeks (range, 25-36 weeks ) and mean birth weight 1093 g (range 630-2750 g). Infants were regula rly monitored to maintain pulse oximeter O-2 saturation over 94%-95%. The source of O-2 was liquid oxygen and was delivered by nasal cannula . During the follow up oxygenation was assessed by SatO(2) measurement , cardiac function by Doppler echocardiography and respiratory functio n by the occlusion technique. All patients had an ophthalmological fol low up. The mean age of the infants at discharge was 3.7 months (range 1.7-8.6) and mean weight 2830 g (range 2150-3780 g). At discharge 8 i nfants had right ventricular hypertrophy (RVH) and four of them had pu lmonary hypertension. Mean duration of home O-2 therapy was 97 days (r ange 15-320 days) and the mean age of discontinuation of O-2 was 6.9 m onths !range 3-14.7 months). The cardiological follow up was benign: t he ECG signs of RVH disappeared by 12 months of age in six out of eigh t infants and the right ventricular pulmonary pressure, as measured by the Doppler method, normalised in the four patients in whom it was de tected. No relationship was found between respiratory mechanics and th e duration of O-2 therapy. Weight gain was poor with mean growth at th e 3rd percentile for females and just below the 3rd percentile for mal es. Twelve of the 21 infants required 25 rehospitalizations. No one pr esented deterioration of retinopathy of prematurity that was present i n 16 infants at discharge; at 12 months retinopathy was resolved in 14 infants, A total of 2025 hospital days were saved, representing a sig nificant financial saving. Conclusion Home O-2 therapy permits the saf e early discharge of O-2-dependent BPD infants and it reduces signific antly the length of time spent in hospital which represents a consider able financial saving.