Among Canadian Pediatric respirologists, is there variability on decision to discontinue supplemental oxygen in premature patients with bronchopulmonary dysplasia? A cross-sectional survey study

Abstract

RATIONALE AND OBJECTIVE: Bronchopulmonary dysplasia (BPD) is defined as the persistent need for oxygen at 36 weeks post menstrual age or 28 days of postnatal life in premature infants. Close to half of all premature infants with BPD are discharged from hospital with supplemental home oxygen and pediatric respirologists are commonly involved in the decision of discontinuing supplemental oxygen use. Our objective was to assess whether there is variability among Canadian pediatric respirologists on when to discontinue supplemental oxygen given the lack of evidence-based guidelines shaping this decision-making process. METHODS: Ethics approval was obtained and a cross sectional survey study was completed. Online and paper surveys included 4 oximetry test results and clinical vignettes provided in both English and French. Descriptive statistics were obtained for quantitative variables and data were analyzed for significance using the STATA statistical analysis software. RESULTS: The survey response rate was 27%. The decision to discontinue home oxygen did vary based on the province of current work; Alberta had the highest rate of respondents choosing to discontinue home oxygen (47.5%) in comparison to British Columbia and Quebec (18 and 20%, respectively; chi-square 3.97, p = 0.403). The years of experience of the physician was associated with a higher use of a guideline in making decisions on supplemental oxygen use (3.1 vs. 1.8, p = 0.167). CONCLUSION: This project allowed us to gather data on current decision making practices on home oxygen use among Canadian pediatric respirologists and informs that there is variability on care that patients receive across the country.