HOME CARE (HC) OF INFANTS WITH BRONCHOPULMONARY DYSPLASIA (BPD) AND OXYGEN (OD)

Abstract

Newborns who develop BPD and OD have costly hospitalizations and prolonged separation from their families. HC was provided to 26 ventilator independent infants who had BPD and required supplemental O₂ to maintain a TcPO₂ ⩾50-60mmHg. Practicability of HC was assessed in 13/26 at age >6 months.(x̄=20.3 mo). Mean GA was 28 wk. Birth weight 1307 g, days on ventilation 79, hospital days 179. Morbidity included 11 patients that had HMD, 8 IVH, 4 PDA, 3 persistent fetal circulation, 11 ROP, and 4 GE reflux. All parents were high school educated and had health insurance. Parents' training prior to HC included feeding techniques, handling of O₂ concentrator, administration of medication, and if indicated, use of monitor and CPR. Only few families required HC nursing. At present, 11/13 are off O₂ (mean age cessation, 9 mos), 10/13 are fed entirely P.O. and 3 (ages 15-41 mos) are still fed by N.G. tube or gastrostomy. Six/13 had 13 readmissions, 38% related to pulmonary and 62 to GI/feeding problems. Nine remain <5% for corrected age in weight, 8 for length, and 4 FOC. Despite the physical demands of providing constant care at home, parents report that with HC life was better organized, attachment improved, and expenses reduced up to 96%. Few had initial difficulties with O₂ use. Feeding related problems are the major concern. Conclusion: Home care of oxygen dependent infants is a viable option to chronic hospitalization.

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