Introduction: Preterm children with bronchopulmonary dysplasia
(BPD) frequently require supplemental oxygen in the outpatient setting.
In this study, we sought to determine patient characteristics and
demographics associated with need for supplemental oxygen at initial
hospital discharge, timing to supplemental oxygen liberation, and
associations between level of supplemental oxygen and likelihood of
respiratory symptoms and acute care usage in the outpatient setting.
Methods: A retrospective analysis of subjects with BPD on
supplemental oxygen (O 2) was performed. Subjects were
recruited from outpatient clinics at Johns Hopkins University and the
Children’s Hospital of Philadelphia between 2008 and 2021. Data were
obtained by chart review and caregiver questionnaires. Results:
Children with BPD receiving > 1 liter of O
2 were more likely to have severe BPD, pulmonary
hypertension and be older at initial hospital discharge. Children
discharged on higher levels of supplemental O 2 were
slower to wean to room air compared to lower O 2 groups
(p<0.001). Additionally, weaning off supplemental O
2 in the outpatient setting was delayed in children with
gastrostomy tubes and those prescribed inhaled corticosteroids, on
public insurance or with lower estimated household incomes. Level of
supplemental O 2 at discharge did not influence
outpatient acute care usage or respiratory symptoms.
Conclusion: BPD severity and level of supplemental oxygen use
at discharge did not correlate with subsequent acute care usage or
respiratory symptoms in children with BPD. Weaning of O
2 however was significantly associated with
socioeconomic status and respiratory medication use, contributing to the
variability in O 2 weaning in the outpatient setting.