Ryo Ogawa, Masaki Hasebe, Tomohiko Nakamura, Fumihiko Namba
Nagano Children’s Hospital. Saitama Medical Center and Saitama Medical University.
Japan
Journal of Paediatrics and Child Health
J Paediatr Child Health 2025;
DOI: 10.1111/jpc.70150
Abstract
Aim: To examine variations in home oxygen therapy (HOT) initiation and management practices for bronchopulmonary dysplasia (BPD) among perinatal medical centres in Japan.
Methods: A questionnaire survey was distributed to 112 perinatal medical centres in Japan from September to October 2023. Responses were collected from supervising neonatologists at each centre.
Results: The response rate was 91.1% (102/112). All centres utilised percutaneous oxygen saturation (SpO2) levels as a criterion for initiating HOT, with thresholds ranging from 90% to 95%; the most common threshold was 95% (37%). However, 17% of centres lacked defined threshold criteria. Only 35% had standards for the duration or frequency of subthreshold SpO2 levels; 11% initiated HOT when SpO2 fell below the threshold for ≥ 10% of the time. Pulmonary hypertension assessments were performed before discharge at 83% of facilities but continued post-discharge in only 30%. Home pulse oximetry monitoring was implemented at 84% of centres, primarily for discontinuing HOT (95%) and detecting respiratory deterioration (90%). For discontinuation, 66% used a threshold of ≥ 95%, but 69% lacked criteria for duration or frequency. Additionally, 67% relied on family-reported SpO2 data, with only 14% analysing oximeter data.
Conclusions: Significant variability exists in HOT practices among Japanese perinatal centres. These findings emphasise the need for standardised, evidence-based guidelines to enhance the management and outcomes of infants with BPD.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Medical Therapy. Efficacy or Lack of Efficacy
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
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