A family-centric, comprehensive nurse-led home oxygen programme for neonatal chronic lung disease: home oxygen policy evaluation (HOPE) study.

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Perinatal Medicine Pub Date : 2024-11-18 DOI:10.1515/jpm-2024-0319

Nele Legge, Dominic Fitzgerald, Jacqueline Stack, Himanshu Popat

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引用次数: 0

Abstract

Objectives: Considerable variation and little objective evidence exists to guide the use of supplemental oxygen therapy in infants with neonatal chronic lung disease (nCLD) after hospital discharge. We developed a new policy utilizing regular oximetry downloads to help determine commencement and titration of low flow oxygen. The aim of this policy is to improve safety and uniformity in practice and potentially lead to improvements in outcomes including the number of infants being discharged on home oxygen therapy (HOT) and length of stay (LOS).

Methods: This single-centre pre- and post-implementation study included 86 and 94 infants <32 weeks' gestation (pre- vs. post-implementation) meeting definition of nCLD. The primary outcomes were (1) successful implementation of the new policy, (2) changes in number of patients discharged on HOT and (3) in LOS. Secondary outcomes were changes in feeding mode at discharge, total length of HOT, readmission to hospital within the first year of life and neurodevelopmental outcomes at 8 months post menstrual age amongst infants treated with HOT.

Results: The policy was successfully implemented with 100 % of infants with nCLD receiving downloads in the post-implementation epoch. Pre-implementation 36 % (31 of 85) of infants with nCLD were treated with HOT vs. 17 % (16 of 94) post-implementation (p=0.03). There was no significant difference in LOS or any of the secondary outcomes.

Conclusions: A protocolised approach to decision making using predetermined parameters regarding the need for supplemental oxygen in neonates with nCLD is practical and achievable and may result in fewer neonates requiring HOT.

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针对新生儿慢性肺病的以家庭为中心、由护士主导的综合性家庭供氧计划：家庭供氧政策评估（HOPE）研究。

目的：在指导患有新生儿慢性肺病 (nCLD) 的婴儿出院后使用补充氧疗法方面，存在着相当大的差异，而且几乎没有客观证据。我们制定了一项新政策，利用定期血氧仪下载来帮助确定低流量氧气的开始和滴定。该政策旨在提高实践的安全性和统一性，并有可能改善治疗效果，包括接受家庭氧疗（HOT）出院的婴儿人数和住院时间（LOS）：方法：这一单中心实施前和实施后研究分别纳入了 86 名和 94 名婴儿：政策成功实施后，100% 的 nCLD 婴儿接受了下载。实施前，36% 的 nCLD 患儿（85 例中的 31 例）接受了 HOT 治疗，而实施后，17% 的 nCLD 患儿（94 例中的 16 例）接受了 HOT 治疗（P=0.03）。LOS或任何次要结果均无明显差异：结论：使用预先确定的参数对患有 nCLD 的新生儿是否需要补充氧气进行决策的协议化方法是切实可行的，可减少需要 HOT 的新生儿人数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatal Medicine 医学-妇产科学

CiteScore

4.40

自引率

8.30%

发文量

183

审稿时长

4-8 weeks

期刊介绍： The Journal of Perinatal Medicine (JPM) is a truly international forum covering the entire field of perinatal medicine. It is an essential news source for all those obstetricians, neonatologists, perinatologists and allied health professionals who wish to keep abreast of progress in perinatal and related research. Ahead-of-print publishing ensures fastest possible knowledge transfer. The Journal provides statements on themes of topical interest as well as information and different views on controversial topics. It also informs about the academic, organisational and political aims and objectives of the World Association of Perinatal Medicine.