Division of Neonatology, Jiangxi Provincial Children's Hospital, 1666 Diezihu Avenue, Honggutan New Area, Nanchang, 330038, China.
NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, 201102, China.
World J Pediatr. 2023 Jun;19(6):557-567. doi: 10.1007/s12519-022-00591-9. Epub 2022 Aug 11.
Home oxygen therapy (HOT) is indicated upon discharge in some preterm infants with severe bronchopulmonary dysplasia (BPD). There is a lack of evidence-based consensus on the indication for HOT among these infants. Because wide variation in the institutional use of HOT exists, little is known about the role of regional social-economic level in the wide variation of HOT.
This was a secondary analysis of Chinese Neonatal Network (CHNN) data from January 1, 2019 to December 31, 2019. Infants at gestational ages < 32 weeks, with a birth weight < 1500 g, and with moderate or severe BPD who survived to discharge from tertiary hospitals located in 25 provinces were included in this study. Infants with major congenital anomalies and those who were discharged against medical advice were excluded.
Of 1768 preterm infants with BPD, 474 infants (26.8%) were discharged to home with oxygen. The proportion of HOT use in participating member hospitals varied from 0 to 89%, with five of 52 hospitals' observing proportions of HOT use that were significantly greater than expected, with 14 hospitals with observing proportions significantly less than expected, and with 33 hospitals with appropriate proportions. We noted a negative correlation between different performance groups of HOT and median GDP per capita (P = 0.04).
The use of HOT varied across China and was negatively correlated with the levels of provincial economic levels. A local HOT guideline is needed to address the wide variation in HOT use with respect to different regional economic levels in countries like China.
一些患有严重支气管肺发育不良（BPD）的早产儿在出院后需要进行家庭氧疗（HOT）。然而，目前缺乏关于这些婴儿使用 HOT 的循证共识。由于 HOT 在机构中的使用存在广泛的差异，因此对于 HOT 在广泛差异中的应用，我们知之甚少。
这是对中国新生儿网络（CHNN）数据的二次分析，数据来源于 2019 年 1 月 1 日至 2019 年 12 月 31 日。纳入研究的对象为胎龄<32 周、出生体重<1500g、患有中重度 BPD 并存活至三级医院出院的婴儿。排除了有重大先天畸形和出院时未经医嘱的婴儿。
在 1768 例患有 BPD 的早产儿中，有 474 例（26.8%）出院时需要吸氧。参与医院 HOT 的使用率从 0%到 89%不等，其中 5 家医院的 HOT 使用率明显高于预期，14 家医院的 HOT 使用率明显低于预期，而 33 家医院的 HOT 使用率则处于合适的范围。我们注意到不同 HOT 表现组与人均 GDP 中位数之间存在负相关（P=0.04）。
中国 HOT 的使用情况存在差异，与省级经济水平呈负相关。在中国这样的国家，需要制定地方性的 HOT 指南，以解决不同地区经济水平差异导致的 HOT 使用广泛差异的问题。
