Batey Natalie, Batra Dushyant, Dorling Jon, Bhatt Jayesh Mahendra
Nottingham Neonatal Service, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Dept of Academic Child Health, University of Nottingham, Nottingham, UK.
ERJ Open Res. 2019 Mar 25;5(1). doi: 10.1183/23120541.00183-2018. eCollection 2019 Feb.
A new specialised service for preterm infants with bronchopulmonary dysplasia requiring long-term oxygen therapy (LTOT) was established in 2007, led by the paediatric respiratory team, transitioning from neonatal-led follow-up. The new service included the utilisation of a clear protocol. Our objective was to review whether this service initiation led to a reduction of time in LTOT and hospital readmissions.
We performed a retrospective cohort study of infants born at <32 weeks' gestation requiring LTOT in a single tertiary neonatal service. Cases were identified from hospital records, BadgerNet and a local database for two cohorts, 2004-2006 and 2008-2010. Data collected for infants requiring LTOT included demographic details, length of neonatal stay, time in oxygen and hospital attendance rates.
The initiation of the service led to an increase in the number of discharges in LTOT: 13.1% of infants born alive before 32 weeks' gestation in comparison to 3.5% (p<0.001). However, the length of time in LTOT reduced from 15 to 5 months (p=0.01). There was no difference in hospital readmission rates (p=0.365).
In our experience the increase in neonates requiring LTOT is likely to be due to enhanced provision of overnight oximetry studies prior to discharge. Structured monitoring and weaning led to a shorter duration of home oxygen therapy.
2007年，由儿科呼吸团队牵头建立了一项针对需要长期氧疗（LTOT）的支气管肺发育不良早产儿的新专科服务，从以新生儿为主导的随访模式转变而来。这项新服务采用了明确的方案。我们的目的是评估这项服务的启动是否能减少长期氧疗时间和住院再入院率。
我们对在一家三级新生儿专科服务机构中出生孕周小于32周且需要长期氧疗的婴儿进行了一项回顾性队列研究。从医院记录、BadgerNet和一个本地数据库中识别出2004 - 2006年和2008 - 2010年两个队列的病例。收集的需要长期氧疗婴儿的数据包括人口统计学细节、新生儿住院时长、吸氧时间和住院出勤率。
该服务的启动导致长期氧疗出院人数增加：孕周小于32周的存活婴儿中，这一比例从3.5%增至13.1%（p<0.001）。然而，长期氧疗时间从15个月减少至5个月（p=0.01）。住院再入院率没有差异（p=0.365）。
根据我们的经验，需要长期氧疗的新生儿数量增加可能是由于出院前加强了夜间血氧饱和度监测。结构化监测和撤机导致家庭氧疗时间缩短。
