ELIMINATING SLEEP-ASSOCIATED HYPOXEMIA IMPROVES GROWTH IN INFANTS WITH BRONCHOPULMONARY DYSPLASIA

Objective. Infants with bronchopulmonary dysplasia (BPD) have been pre viously reported to have a decrease in growth velocity after stopping supplemental oxygen (SO). SO was stopped after a short-term recording (20-30 minutes) of pulse oxygen saturation (SaO(2)) of 92% or greater in room air. Other studies have documented that SaO(2) decreases furth er during feedings and sleep in infants with BPD. Two questions were a sked: (1) whether short-term, awake SaO(2) studies would reliably pred ict prolonged sleep Sao; and (2) how SaO(2) sustained at 88% to 91% vs 92% or greater in room air would impact growth velocity in infants wi th BPD. Methodology. Short-term SaO(2) studies were prospectively comp ared with prolonged sleep SaO(2) (n = 63) and the growth velocity of i nfants who had SO discontinued after a prolonged sleep SaO(2) recordin g of 88% to 91% (group 1; n = 14) versus 92% or greater (group 2;n = 3 4) in room air. Results. Failure to maintain SaO(2) at predetermined l evels occurred in 18 (29%) of 63 infants during their first prolonged sleep study. There was no correlation between short-term awake SaO(2) and prolonged sleep SaO(2) recordings (r = .02). Body weight, height, weight for height, and rate of weight gain were similar for all study infants before SO was stopped and remained constant for group 2 infant s after SO was stopped. However, group 1 infants had a significant dec rease in the rate of weight gain (17.3 + 13.1 vs 3.7 + 6.1 g/kg per da y), and the mean,scores for weight gain and weight for height also dec reased significantly for group 1 infants. Energy intake, incidence of acute infection, hematocrit values, and medication use did not differ before or after stopping SO in either group. Conclusions. This study i ndicated that short-term, awake SaO(2) measurements do not predict pro longed sleep SaO(2) and overall, infants with BPD continued a positive growth trend when SaO(2) remained greater than 92% during prolonged s leep.