Trends of respiratory medication in premature infants discha
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Roughly half of all extremely preterm infants will be diagnosed with bronchopulmonary dysplasia (BPD), and a third will be discharged on home oxygen therapy (HOT). Bronchopulmonary dysplasia (BPD) continues to be the most prevalent morbidity affecting premature infants, and with recent advancements, more infants are surviving past neonatal intensive care unit (NICU) discharge with moderate‐to‐severe lung disease. To date, there have been no studies that have examined the relationship between respiratory medication utilization in infants with BPD on HOT

Infants were enrolled at first outpatient pulmonary or neonatal intensive care unit (NICU) follow‐up visit with a pulmonary component. Respiratory medication prescriptions and dosage were collected from the time of enrollment through 6 months after HOT discontinuation. Patients were seen monthly while on HOT and at 1, 3, and 6 months after successful discontinuation.

During protocol visits,174 (89%) infants had respiratory medications documented. Respiratory medication use was higher at initial follow‐up visit compared with NICU discharge and decreased at the final 6‐month follow‐up visit. Infants who received inhaled steroids (IS) before weaning had a mean HOT duration of 138 days infants who received IS after weaning had a shorter mean HOT duration. In the time‐to‐event analysis the no IS group and the postwean group differed significantly. NICU clinics gave a total of 35 prescriptions to 43 patients, an average of 0.8 per patient, while the pulmonary clinics gave 837 prescriptions to 153 patients or 5.5 per patient.

Conclusively, Respiratory prescribing patterns for infants on HOT are highly variable. The utilization of IS was not associated with a shorter duration of HOT. The findings of this study confirm the high variability of respiratory medication utilization amongst providers. Inhaled corticosteroid utilization was not associated with a shorter duration of HOT. These results highlight the need for future clinical trials that prove the safety and efficacy of respiratory medication treatment for BPD.

Source: https://onlinelibrary.wiley.com/doi/abs/10.1002/ppul.24735?af=R
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