Variability in Home Oxygen Therapy Practices for Bronchopulmonary Dysplasia in Japan: A Questionnaire Survey.

Abstract

Aim: To examine variations in home oxygen therapy (HOT) initiation and management practices for bronchopulmonary dysplasia (BPD) among perinatal medical centres in Japan.

Methods: A questionnaire survey was distributed to 112 perinatal medical centres in Japan from September to October 2023. Responses were collected from supervising neonatologists at each centre.

Results: The response rate was 91.1% (102/112). All centres utilised percutaneous oxygen saturation (SpO₂) levels as a criterion for initiating HOT, with thresholds ranging from 90% to 95%; the most common threshold was 95% (37%). However, 17% of centres lacked defined threshold criteria. Only 35% had standards for the duration or frequency of subthreshold SpO₂ levels; 11% initiated HOT when SpO₂ fell below the threshold for ≥ 10% of the time. Pulmonary hypertension assessments were performed before discharge at 83% of facilities but continued post-discharge in only 30%. Home pulse oximetry monitoring was implemented at 84% of centres, primarily for discontinuing HOT (95%) and detecting respiratory deterioration (90%). For discontinuation, 66% used a threshold of ≥ 95%, but 69% lacked criteria for duration or frequency. Additionally, 67% relied on family-reported SpO₂ data, with only 14% analysing oximeter data.

Conclusions: Significant variability exists in HOT practices among Japanese perinatal centres. These findings emphasise the need for standardised, evidence-based guidelines to enhance the management and outcomes of infants with BPD.