Home Oxygen Therapy for Thai Preterm Infants with Bronchopulmonary Dysplasia: A 20-year Review

Background: Consequences of lung injury and inflammation in preterm infants with bronchopulmonary dysplasia (BPD) contribute to prolonged oxygen requirements. We aim to identify the median age of home oxygen discontinuation and the factors that might predict longer use of home oxygen therapy. Methods: All preterm (≤36 weeks’ gestation) infants diagnosed BPD who required home oxygen therapy in Ramathibodi hospital during January 2000 – December 2019 were recruited in this retrospective study. Timing of home oxygen withdrawal were identified as the primary outcome. Demographic data, severity of BPD, history of respiratory support, procedures, prenatal history, comorbidities, and complications were recorded and analyzed as the associated factors of home oxygen withdrawal. Results: Of the 40 infants, 18 (45%) successfully weaned oxygen within 12 months. The median corrected age (CA) of oxygen withdrawal was 13.8 months (8.5, 22.1). Longer duration of total respiratory support, longer length of hospital stay, and poor weight gain were associated with longer duration of oxygen use. Infants who gained higher weight at oxygen withdrawal were associated with shorter duration of home oxygen use at 12 months CA (adjusted OR, 1.97; 95% CI, 1.13-3.23; p = 0.015) and 15 months CA (adjusted OR, 1.98; 95% CI, 1.20-3.27; p = 0.007). Conclusions: The median corrected age of oxygen withdrawal in Thai BPD infants was 13.8 months. Factors associated with prolonged home oxygen use included longer duration of respiratory support, length of hospital stay, severe BPD, and poor weight gain.