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G529(P) Flow rate as a predictor of weaning home oxygen in babies with bronchopulmonary dysplasia
  1. K Millard1,
  2. M Hurley2,
  3. A Prayle2,
  4. D Batra1,
  5. JM Bhatt2
  1. 1Neonatal Intensive Care, Nottingham University Hospitals NHS Trust, Nottingham, UK
  2. 2Department of Respiratory Paediatrics, Nottingham University Hospitals NHS Trust, Nottingham, UK

Abstract

Aims There are currently no evidence-based guidelines available to assist in the weaning of home oxygen for babies with bronchopulmonary dysplasia (BPD). Our local care pathway follows a programme of weaning under which babies come off oxygen after reaching a flow rate of 0.1 l/min and maintaining saturations of 93% or above for a period of 2 h in air. Previous small studies have suggested that flow rates of less than 20cm3/kg/min may be a predictor of success in coming off oxygen. The aim of this study was to explore the flow rates in babies ready to come off oxygen.

Methods All babies known to our tertiary respiratory service born between April 2007 and May 2015, and who had successfully weaned from home oxygen for BPD were included (n = 156). The date oxygen is stopped is prospectively recorded. Weight at the time of coming off oxygen was established from the patient records and used to calculate flow rates in cm3/kg/min. Twenty-four babies were excluded as the weight at the time of stopping oxygen was not available.

Results 132 babies were included in the analysis. Mean weight at cessation of home oxygen was 6.61kg (SD 1.75kg), with a mean flow rate of 16.27cm3/kg/min (SD 4.65 cm3/kg/min). Flow rates in 109/132 babies (82.5%) were <20 cm3/kg/min at the time of successful weaning.

Conclusion Successful weaning from home oxygen in a large cohort of babies with BPD is associated with pre-weaning flow rates of less than 20cm3/kg/min. This confirms previous suggestions that this may be a useful predictor of readiness to come off oxygen. We are planning to prospectively validate whether the flow rate based on weight is a useful indicator of readiness to wean from oxygen.

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