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支气管肺发育不良患儿出院后的氧疗撤机

Oxygen weaning after hospital discharge in children with bronchopulmonary dysplasia.

作者信息

Yeh Jennifer, McGrath-Morrow Sharon A, Collaco Joseph M

机构信息

Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland.

出版信息

Pediatr Pulmonol. 2016 Nov;51(11):1206-1211. doi: 10.1002/ppul.23442. Epub 2016 Apr 19.

Abstract

BACKGROUND

In the United States, approximately 12,000 preterm infants are diagnosed with bronchopulmonary dysplasia (BPD) and many of these infants require supplemental oxygen after initial hospital discharge. In children with BPD we sought to identify factors associated with supplemental oxygen use after initial hospital discharge, factors associated with duration of supplemental oxygen use, and methods used to wean off supplemental oxygen in the home environment.

METHODS

All subjects (n = 420) with the diagnosis of BPD were recruited from a single center Bronchopulmonary Dysplasia Clinic between 2008 and 2013. Subject information was obtained from patient history records, patient demographics, and caregiver questionnaires.

RESULTS

Younger gestational age and having a Nissen fundoplication were associated with home supplemental oxygen use in subjects with BPD. Of the 154 subjects who received supplemental oxygen at home, 38% received flows ≤1/8 LPM, 30% received flows >1/8 LPM and ≤1/4 LPM, 21% received flows >1/4 LPM and ≤1/2 LPM, and 11% received flows >1/2 LPM. Among subjects receiving ≤1/8 LPM of oxygen, the median age of weaning off oxygen was 10.1 months, but increased depending on level of oxygen flow at initial outpatient visit. Of the 137 subjects weaned off of oxygen during the study period, weaning was not supervised by a physician in 32.1% of subjects.

CONCLUSION

Home supplemental oxygen use is common in infants diagnosed with BPD. In this study, the median age of weaning off supplemental oxygen was 10.1 months after initial hospital discharge. Unsupervised weaning of supplemental oxygen occurred in 32.1% of subjects with BPD. Pediatr Pulmonol. 2016;51:1206-1211. © 2016 Wiley Periodicals, Inc.

摘要

背景

在美国,约有12,000名早产儿被诊断患有支气管肺发育不良(BPD),其中许多婴儿在初次出院后仍需要补充氧气。在患有BPD的儿童中,我们试图确定初次出院后与补充氧气使用相关的因素、与补充氧气使用持续时间相关的因素,以及在家中环境中断氧的方法。

方法

2008年至2013年期间,从单一中心的支气管肺发育不良诊所招募了所有诊断为BPD的受试者(n = 420)。受试者信息来自患者病史记录、患者人口统计学资料和照顾者问卷。

结果

胎龄较小和接受了nissen胃底折叠术与患有BPD的受试者在家中补充氧气使用相关。在154名在家中接受补充氧气的受试者中,38%接受的流量≤1/8升/分钟,30%接受的流量>1/8升/分钟且≤1/4升/分钟,21%接受的流量>1/4升/分钟且≤1/2升/分钟,11%接受的流量>1/2升/分钟。在接受≤1/8升/分钟氧气的受试者中,断氧的中位年龄为10.1个月,但根据初次门诊时的氧气流量水平而增加。在研究期间断氧的137名受试者中,32.1%的受试者断氧未受医生监督。

结论

在家中补充氧气在诊断为BPD的婴儿中很常见。在本研究中,初次出院后断氧的中位年龄为10.1个月。32.1%的BPD受试者断氧未受监督。《儿科肺病学》。2016;51:1206 - 1211。©2016威利期刊公司。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8327/5556369/d956365504f9/nihms892804f1.jpg

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