Duration of Home Oxygen Therapy in Preterm Infants Utilizing a Remote Patient Monitoring Program to Wean: Trajectory Patterns

Abstract

Background Up to one-third of preterm infants diagnosed with bronchopulmonary dysplasia will require home oxygen therapy (HOT) after hospital discharge. Currently, no consensus-based guidelines exist for safely managing HOT. The Recorded Home Oximetry (RHO) trial was the first to evaluate a structured weaning guideline. At the conclusion of the trial, our home institution implemented the RHO program in June 2019, utilizing the same RHO protocol as the original trial. The purpose of this project was to evaluate the duration and weaning trajectory of infants followed and identify any risk factors associated with flow rate increases or longer trajectories. Methods This is a prospective analysis of infants born <37 weeks gestation followed by the RHO program between June 2019 and June 2021. Results The study included 26 infants with a total of 407 RHO epochs. There was nearly equal distribution of males and females with a mean birth gestational age of 27.5 (±3.4 SD) weeks. The median time of successful discontinuation of HOT was 2.1 months. Infants starting on higher initial flow rates had faster weaning trajectories compared to those who started on lower flow rates ( P value <.0001). Infants born small for gestational age were about twice as likely to have longer maintenance on one flow rate compared to appropriate for gestational age infants (RR = 2.81, 95% CL 1.64-4.81, P = .0002). Conclusion The RHO program, a structured telemedicine weaning guideline, reduces the duration of HOT in preterm infants and does not cause unnecessary swings in oxygen flow rates.