Clinical Analysis of NICU Oxygen Therapy over 28 Days in a Single Center

Abstract

Objective — To investigate the main causes, related factors and clinical outcomes of neonates with continuous oxygen therapy ≥ 28 days in neonatal intensive care unit（NICU） of our hospital. Methods — Clinical data of neonates admitted to NICU from January 2015 to December 2020 who needed continuous oxygen therapy ≥ 28 days after birth were retrospectively analyzed. The causes of continuous oxygen therapy ≥ 28 days, general condition with oxygen and respiratory support, duration and clinical outcomes were recorded. Independent samples t test, Mann-Whitney rank sum test, c² test were used for statistical analysis. Results — In the past 6 years, 115 cases met the inclusion criteria and who received continuous oxyogen therapy ≥ 28 days after birth. 1. Gestational age: 25+1~40+0, <32 weeks of gestation accounted for 83.5%. The peak gestational age occurred at 28+0~29+6 weeks after continuous oxygen therapy for ≥ 28 days. 2. Main causes: 37 cases (32.2%) of bronchopulmonary dysplasia (BPD), 36 cases (31.3%) of neonatal pneumonia, 20 cases (17.4%) of apnea of prematurity (AOP), Pulmonary hypertension was reported in 8 cases (7.0%), laryngotrachealacia in 2 cases (1.7%), cyanosis congenital heart disease in 4 cases (3.5%), and other causes in 8 cases (7.0%). 3. Short-term prognosis: of 105 premature infants, 90 were successfully deoxygenated, accounting for 85.7%; In 10 cases, 5 cases (50%) were successfully deoxygenated. 20 cases gave up treatment or died. 4. Long-term oxygen therapy was related to gestational age and duration of ventilator. The younger the gestational age, the longer the mechanical ventilation time and the longer the total oxygen therapy time (P < 0.05). Conclusion — Continuous oxygen therapy ≥ 28 days received in all gestational age group. Preterm infants with gestational age < 32 weeks had the highest incidence. The main causes of premature infants with gestational age < 32 weeks are BPD, neonatal pneumonia, AOP and pulmonary hypertension. Neonatal pneumonia was the main cause in preterm infants with gestational age 32+0~34+6 weeks, and congenital dysplasia and genetic metabolic diseases were the main cause in neonates above 35 weeks gestational age group.