Medical College of Wisconsin, Milwaukee, WI, USA.
Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
J Perinatol. 2021 Apr;41(4):772-778. doi: 10.1038/s41372-021-00958-2. Epub 2021 Feb 15.
To determine whether a room air challenge (RAC) correlates with duration of respiratory support for infants with bronchopulmonary dysplasia (BPD).
Prospective study of preterm infants with BPD from 2015 to 2018. Infants receiving ≤2 l flow at 36 weeks postmenstrual age (PMA) underwent RAC. Cox regression was used to adjust the duration of respiratory support after 36 weeks PMA for significant covariates.
Of 161 infants with BPD, 91 were eligible for RAC; 51 passed and 40 failed. Infants who failed RAC had longer respiratory support after 36 weeks PMA than infants who passed (median 19 weeks (IQR 15-33) versus 2 weeks (IQR 1-8, p < 0.001)), which persisted after multivariable adjustment (hazard ratio -1.42, 95% CI -1.94 to -0.91, p < 0.001). Infants failing RAC also had more frequent and longer duration of home oxygen use.
RAC may help provide anticipatory guidance regarding duration of respiratory support for infants with BPD.
确定支气管肺发育不良 (BPD) 婴儿的空气挑战 (RAC) 是否与呼吸支持的持续时间相关。
对 2015 年至 2018 年间患有 BPD 的早产儿进行前瞻性研究。在达到 36 周校正胎龄（PMA）时接受 ≤2 L 流量的婴儿进行 RAC。Cox 回归用于调整 36 周 PMA 后呼吸支持的持续时间，以调整显著协变量。
在 161 名患有 BPD 的婴儿中，有 91 名符合 RAC 条件；51 名通过，40 名失败。在 36 周 PMA 后，RAC 失败的婴儿比通过的婴儿需要更长的呼吸支持（中位数分别为 19 周（IQR 15-33）和 2 周（IQR 1-8，p < 0.001）），这一结果在多变量调整后仍然存在（风险比-1.42，95% CI-1.94 至-0.91，p < 0.001）。RAC 失败的婴儿也更频繁地使用氧气，并且持续时间更长。
RAC 可能有助于为 BPD 婴儿提供关于呼吸支持持续时间的预期指导。
