Weaning oxygen in infants with bronchopulmonary dysplasia |
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| Affiliation: | 1. Department of Respiratory Paediatrics, Southampton Children’s Hospital, Southampton, UK;2. Department of Paediatrics, Basingstoke and North Hampshire Hospital, Basingstoke, UK;3. Department of Respiratory Paediatrics, Nottingham Children''s Hospital, Nottingham, UK;4. Department of Neonatal Medicine, Southampton Children''s Hospital, Southampton, UK;5. NIHR Biomedical Research Centre Southampton, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK;6. Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK;7. Neonatal and Paediatric Neurology, Southampton Children’s Hospital, Southampton, UK;1. Clinical Ethics Service, Sydney Children’s Hospital Network, Children’s Hospital at Westmead and Sydney Children’s Hospital, Randwick, Australia;2. Sydney Health Ethics, 92/94 Parramatta Rd, Camperdown, NSW 2050, Australia;1. Department of Paediatrics, University of Otago at Christchurch, PO Box 4345, Christchurch 8140, New Zealand;2. Department of Obstetrics and Gynaecology, University of Cambridge, 223, Level 2, The Rosie Hospital, Robinson Way, Cambridge CB2 2SW, UK;1. Department of Paediatrics, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia;2. Paediatric Emergency Department, Monash Medical Centre, Monash Emergency Service, Monash Health, Clayton, Australia;3. Emergency Research, Murdoch Children''s Research Institute, Parkville, Australia;4. Paediatric Research in Emergency Departments International Collaborative (PREDICT), Melbourne, Australia;5. Departments of Surgery and Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand;6. Children''s Emergency Department, Starship Children''s Hospital, Auckland, New Zealand;7. Department of Emergency Medicine, Sidra Medicine, Doha, Qatar;8. School of Medicine, Cardiff University, Cardiff, UK;9. Department of Medicine, Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia;10. Monash Emergency Service, Monash Health, Dandenong Hospital, Dandenong, Australia;11. Emergency Department, Royal Children''s Hospital, Parkville, Australia;12. Department of Paediatrics and Centre for Integrated Critical Care, University of Melbourne, Parkville, Australia;13. Cochrane Hypertension Group, Faculty of Medicine, University of British Columbia, Vancouver, Canada;1. SAHMRI Microbiome Research Laboratory, Flinders University College of Medicine and Public Health, Adelaide, SA 5000, Australia;2. Microbiome and Host Health, South Australia Health and Medical Research Institute, North Terrace, Adelaide, SA 5000, Australia;3. Faculty of Health and Medicine, Priority Research Centre for Healthy Lungs, The University of Newcastle, Callaghan, New South Wales, Australia;4. Hunter Medical Research Institute, Newcastle, New South Wales, Australia;1. Department of Respiratory Medicine, The Children’s Hospital at Westmead, Sydney, NSW 2145, Australia;2. Discipline of Child & Adolescent Health, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW 2145, Australia;3. Department of Paediatrics, Shoalhaven District Memorial Hospital, Nowra 2541, Australia |
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| Abstract: | Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease commonly seen in preterm infants as the sequelae following respiratory distress syndrome. The management of evolving BPD aims to minimise lung injury and prevent the impact of hypoxia and hyperoxia. Proposed morbidities include respiratory instability, pulmonary hypertension, suboptimal growth, altered cerebral oxygenation and long-term neurodevelopmental impairment. The ongoing management and associated morbidity present a significant burden for carers and healthcare systems. Long-term oxygen therapy may be required for variable duration, though there is a lack of consensus and wide variation in practise when weaning supplemental oxygen. Furthermore, a shift in care towards earlier discharge and community care underlines the importance of a structured discharge and weaning process that eliminates the potential risks associated with hypoxia and hyperoxia. This review article describes recent evidence outlining oxygen saturation reference ranges in young infants, on which structured guidance can be based. |
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| Keywords: | Bronchopulmonary dysplasia Oxygen Oximetry Preterm infant Saturations Sleep study |
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