LAUSR

BACKGROUND Approximately a third of all extremely preterm infants diagnosed with bronchopulmonary dysplasia will require home oxygen therapy (HOT). Lack of consensus-based guidelines has led to significant variability in outpatient HOT management in the United States. A common assessment performed prior to discontinuing oxygen is a formal polysomnogram (PSG). PSGs are potentially undesirable due to cost, lack of convenient access, and parental stress, so alternative testing to determine optimal timing of safe oxygen discontinuation are needed. METHODS We compared nocturnal recorded home oximetry (RHO) with PSG data in a cohort of patients from the Recorded Home Oximetry (RHO) trial for patients who had recordings performed simultaneous to or within 24 hours of their PSG. The RHO trial was a randomized, unblinded, multi-center trial comparing two oxygen management strategies. Parameters of oxygenation were compared between PSG and RHO, and non-oximetry findings from the PSG that changed clinical management were identified. RESULTS A total of 53 infants randomized to obtain a PSG as part of the RHO trial (55%) completed a PSG, and of those, 32 (64%) completed both a PSG with comparison RHO. There were more white infants in both groups than other races and ethnicities. Bland-Altman analysis showed a strong agreement of oxygen saturation time below 90% SpO2 between PSG and RHO results (slope= 1.014, p=0.24). Results agreed in 96% of cases. CONCLUSION RHO is a safe and effective alternative to PSG to assist in determination of discontinuing HOT in infants with BPD without other risks for sleep disordered breathing. This article is protected by copyright. All rights reserved.