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Impact of a protocol-driven unified service for neonates with bronchopulmonary dysplasia

Impact of a protocol-driven unified service for neonates with bronchopulmonary dysplasia
Impact of a protocol-driven unified service for neonates with bronchopulmonary dysplasia

Aim: 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. 

Methods: we performed a retrospective cohort study of infants born at lt;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. 

Results: 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). 

Conclusions: 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.

2312-0541
Batey, Natalie
f2f843a1-8ac7-4f94-8b81-9257c7a4a0ac
Batra, Dushyant
80313b63-1f03-4572-a107-b129b5b652ca
Dorling, Jon
e55dcb9a-a798-41a1-8753-9e9ff8aab630
Bhatt, Jayesh Mahendra
8386e4a0-ecdd-4d41-ac89-ac87665d9a67
Batey, Natalie
f2f843a1-8ac7-4f94-8b81-9257c7a4a0ac
Batra, Dushyant
80313b63-1f03-4572-a107-b129b5b652ca
Dorling, Jon
e55dcb9a-a798-41a1-8753-9e9ff8aab630
Bhatt, Jayesh Mahendra
8386e4a0-ecdd-4d41-ac89-ac87665d9a67

Batey, Natalie, Batra, Dushyant, Dorling, Jon and Bhatt, Jayesh Mahendra (2019) Impact of a protocol-driven unified service for neonates with bronchopulmonary dysplasia. ERJ Open Research, 5 (1), [00183-2018]. (doi:10.1183/23120541.00183-2018).

Record type: Article

Abstract

Aim: 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. 

Methods: we performed a retrospective cohort study of infants born at lt;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. 

Results: 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). 

Conclusions: 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.

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More information

Accepted/In Press date: 28 January 2019
Published date: 25 March 2019
Additional Information: Funding Information: Conflict of interest: N. Batey has nothing to disclose. D. Batra reports a conference and travel bursary to attend the Joint European Neonatal Societies conference in 2017 from the British Association of Perinatal Medicine which was funded by Chiesi Limited. J. Dorling has nothing to disclose. J.M. Bhatt has nothing to disclose.

Identifiers

Local EPrints ID: 485082
URI: http://eprints.soton.ac.uk/id/eprint/485082
ISSN: 2312-0541
PURE UUID: 7600230e-5153-47aa-bb8f-1fcf114af596
ORCID for Jon Dorling: ORCID iD orcid.org/0000-0002-1691-3221

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Date deposited: 29 Nov 2023 17:32
Last modified: 18 Mar 2024 04:16

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Contributors

Author: Natalie Batey
Author: Dushyant Batra
Author: Jon Dorling ORCID iD
Author: Jayesh Mahendra Bhatt

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