Experience with Home Oxygen in the Management of Infants with Bronchopulmonary Dysplasia

Abstract

We followed the clinical course of 23 infants with bronchopulmonary dysplasia (BPD) on home oxygen therapy during the first year of life in order to monitor patterns of growth, need for hospital readmission, and improvement in oxygenation. Oxygenation was assessed by serial, resting, awake, and room air transcutaneous PO2 (tcPO2) measurements at clinic visits. Weight gain was poor, with boys growing below the fifth percentile and girls growing at the tenth percentile. Ten of the 23 infants (43%) required rehospitalizations. There were no deaths. Fourteen of the 23 infants (61%) were taken off supplemental oxygen by 12 months corrected age, at a mean age of 7.9 months. Mean rate of improvement in tcPO2 was 3 torr/month, but wide individual variation was found. Infants off of oxygen treatment at 12 months corrected age grew at a significantly greater rate than those still requiring oxygen supplementation (p < 0.02). Infants with right ventricular hypertrophy (RVH) by electrocardiogram tended to resolve their RVH while on home oxygen therapy. We conclude that infants with BPD on home oxygen therapy generally show steady improvement in oxygenation, but grow poorly and require frequent hospitalizations.