title: Infants with chronic neonatal lung disease: recommendations for the use of home oxygen therapy.
abstract: Chronic neonatal lung disease (CNLD) is defined as a supplemental oxygen requirement beyond 36 weeks' postmenstrual age, with more severely affected infants requiring oxygen beyond a full-term-equivalent age. Low-flow supplemental oxygen facilitates discharge from hospital of infants with CNLD who develop hypoxia in air. There is a lack of data on the most appropriate minimum mean target oxygen saturation (Spo(2)) level. Reflecting a variety of clinical practices and infant comorbidities (frequency of oxygen desaturation, presence of pulmonary hypertension, retinopathy of prematurity, and adequacy of growth), the minimum mean target range for Spo(2) during overnight oximetry should be 93%-95%. The effect of supplemental oxygen on carbon dioxide retention should be considered before deciding on an oxygen flow. Most infants with CNLD are not ready for discharge until their supplemental oxygen requirement is < or = 0.5 litres per minute delivered through a nasal cannula. The safety of short-term disconnection from supplemental oxygen should be assessed before discharge. Assessment of oxygenation during sleep with continuous overnight oximetry or polysomnography is recommended when weaning infants from supplemental oxygen. Discontinuation of oxygen therapy is based on clinical assessments and documentation of adequate oxygenation in room air. There is limited objective evidence on which to base recommendations.
authors.affiliation: Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia. dominif2@chw.edu.au
authors.forename: Dominic A
authors.initials: DA
authors.lastname: Fitzgerald
authors.forename: R John H
authors.initials: RJ
authors.lastname: Massie
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Nixon
authors.forename: Adam
authors.initials: A
authors.lastname: Jaffe
authors.forename: Andrew
authors.initials: A
authors.lastname: Wilson
authors.forename: Louis I
authors.initials: LI
authors.lastname: Landau
authors.forename: Jacob
authors.initials: J
authors.lastname: Twiss
authors.forename: Greg
authors.initials: G
authors.lastname: Smith
authors.forename: Claire
authors.initials: C
authors.lastname: Wainwright
authors.forename: Margaret
authors.initials: M
authors.lastname: Harris
mesh_terms: D001315:Australia; D002908:Chronic Disease; D006699:Home Care Services; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D008171:Lung Diseases / Q000628:therapy*; D009520:New Zealand; D010102:Oxygen Inhalation Therapy