Medical College of Wisconsin, Milwaukee, WI.
J Pediatr. 2013 Oct;163(4):976-82.e2. doi: 10.1016/j.jpeds.2013.04.067. Epub 2013 Jun 12.
To compare proportions of infants at different gestational ages discharged from the neonatal intensive care unit (NICU) on home oxygen, to determine how many were classified with chronic lung disease based on timing of discharge on home oxygen, and to determine the percentage discharged on home oxygen who received mechanical ventilation.
We evaluated a retrospective cohort of infants of 23-43 weeks' gestational age discharged from 228 NICUs in 2009, using the Pediatrix Clinical Data Warehouse. Multilevel logistic regression analysis identified predictors of home oxygen use among extremely preterm, early-moderate preterm, late preterm, and term infants. Duration of mechanical ventilation and median length of stay were calculated for infants discharged on home oxygen.
For the 48877 infants studied, the rate of home oxygen use ranged from 28% (722 of 2621) in extremely preterm infants to 0.7% (246 of 34 934) in late preterm and term infants. Extremely preterm infants composed 56% (722 of 1286) of the infants discharged on home oxygen; late preterm and term infants, 19% (246 of 1286). After gestational age, mechanical ventilation was the main predictor of home oxygen use; however, 61% of the late preterm and term infants discharged on home oxygen did not receive ventilation. The median length of hospital stay was 95 days (IQR, 76-114 days) for extremely preterm infants discharged on home oxygen, but only 15 days (IQR, 10-22 days) for late preterm and term ventilated infants discharged on home oxygen.
Although home oxygen use is uncommon in later-gestation infants, the greater overall numbers of later-gestation infants contribute significantly to the increased need for home oxygen for infants at NICU discharge. Neither respiratory failure nor lengthy hospitalization is a prerequisite for home oxygen use at later gestational age.
比较不同胎龄的新生儿重症监护病房（NICU）出院婴儿使用家庭氧疗的比例，确定根据家庭氧疗出院时间有多少例被归类为慢性肺病，并确定使用家庭氧疗出院的婴儿中有多少例接受了机械通气。
我们使用 Pediatrix 临床数据仓库评估了 2009 年从 228 个 NICU 出院的胎龄为 23-43 周的婴儿的回顾性队列。多级逻辑回归分析确定了极早产儿、早中期早产儿、晚期早产儿和足月婴儿使用家庭氧疗的预测因素。计算了使用家庭氧疗出院的婴儿的机械通气持续时间和中位住院时间。
在所研究的 48877 名婴儿中，家庭氧疗使用率从极早产儿的 28%（722/2621）到晚期早产儿和足月婴儿的 0.7%（246/34934）不等。极早产儿中，有 56%（722/1286）的婴儿出院后需要使用家庭氧疗；而晚期早产儿和足月婴儿中，这一比例为 19%（246/1286）。除胎龄外，机械通气是使用家庭氧疗的主要预测因素；然而，61%的使用家庭氧疗的晚期早产儿和足月婴儿并未接受通气。使用家庭氧疗出院的极早产儿的中位住院时间为 95 天（IQR，76-114 天），但接受家庭氧疗出院的晚期早产儿和足月通气婴儿的中位住院时间仅为 15 天（IQR，10-22 天）。
尽管在较晚胎龄的婴儿中，家庭氧疗的使用并不常见，但较晚胎龄婴儿的数量较多，导致 NICU 出院婴儿对家庭氧疗的需求显著增加。在较晚的胎龄阶段，呼吸衰竭或住院时间长并不是使用家庭氧疗的前提条件。
