Aims The British Thoracic Society guidelines state that in infants with chronic lung disease (CLD), oxygen saturations below 90% are associated with an increased risk of apparent life threatening events (ALTE) and saturations below 92% may be associated with suboptimal growth. They recommend that, when assessing infants for the suitability of long term oxygen therapy (LTOT), pulse oximetry should be measured for 6-12 hours and that oxygen saturations should be maintained at 93% or above.
This audit aims to identify national compliance with the BTS guidelines for assessing suitability of LTOT in CLD.
Methods Guidelines for assessment for suitability for LTOT were obtained via telephone survey.
Results 65 randomly selected English NICUs were contacted and 48 responded. 52% carry out pulse oximetry monitoring pre-discharge in infants with CLD to assess need for LTOT. Of these, target saturations were variable, 8% using 93%, 52% below and 40% above this. Although 43% monitored over the recommended time period, 48% monitored for over 12 and 2% for less than 6 hours.
Conclusions Only 4% of units contacted carry out pulse oximetry to assess suitability for LTOT as per BTS guidelines. This suggests that some infants requiring LTOT may not receive this, increasing the risk of ALTE and poor growth. Others may receive unnecessary LTOT, with the associated expense and inconvenience. Local review supports this. These results suggest the need for increasing the awareness of the BTS guidelines amongst English neonatal units.