Aims In infants with chronic neonatal lung disease (CNLD), we aimed to identify predictors of home oxygen duration, predictors of discharge oxygen flow rates, and the association of oxygen flow rates with respiratory outcomes. Methods Infants with CNLD requiring home oxygen in 2016 and 2017 were retrospectively reviewed. Hazard ratios (HR) were estimated from Cox proportional hazards regression models in the cohort. A multinomial logistic regression model examined the effects of maternal and infant variables on discharge oxygen flow rates. Kruskal–Wallis test with univariate linear regression and Fisher's exact test with binomial univariate logistic regression were used to examine associations between oxygen flow groups and post‐discharge clinical variables. Results One hundred and forty‐nine infants were included. Median corrected gestational age (CGA) at oxygen cessation was 6.8 months (interquartile range, 4.4) with 87.2% of infants weaned by 12 months CGA. Shorter initial neonatal intensive care unit (NICU) stay predicted faster oxygen weaning at 9 months (HR, 0.99; 95% confidence interval [CI], 0.98–1.00, p = .02) and 12 months (HR, 0.99; 95% CI, 0.98–1.00, p = .02). Infants with hypercarbia at discharge or discharged from NICU at higher CGA had higher odds of requiring ≥ 200 ml/min relative to ≤ 125 ml/min oxygen. Infants discharged with > 250 ml/min oxygen were more likely to have a respiratory‐related admission before 2 years chronological age. Conclusion Shorter initial NICU stay was the best predictor of earlier home oxygen cessation. At NICU discharge, infants with hypercarbia or a higher CGA may require more home oxygen and experience more respiratory‐related hospital admission in the first 2 years of chronological age.

Aims:  In infants with chronic neonatal lung disease (CNLD), we aimed to identify predictors of home oxygen duration, predictors of discharge oxygen flow rates and the association of oxygen flow rates with respiratory outcomes. Methods:  Retrospective review of infants with CNLD requiring home oxygen in 2016 and 2017.  Hazard ratios (HR) were estimated from Cox proportional hazards regression models in the cohort.  A multinomial logistic regression model examined the effects of maternal and infant variables on discharge oxygen flow rates.  Kruskal-Wallis test with univariate linear regression and Fisher’s exact test with binomial univariate logistic regression were used to examine associations between oxygen flow groups and post-discharge clinical variables. Results:  149 infants were included.  Median corrected gestational age (CGA) at oxygen cessation was 6.8 months (IQR 4.4) with 87.2% of infants weaned by 12 months CGA.  Shorter initial neonatal intensive care unit (NICU) stay predicted faster oxygen weaning at 9 months (HR 0.99, 95%CI 0.98-1.00, p=0.02) and 12 months (HR 0.99, 95%CI 0.98-1.00, p=0.02).  Infants with hypercarbia at discharge or discharged from NICU at higher CGA had higher odds of requiring ≥200mL/min relative to ≤125 mL/min oxygen.  Infants discharged with >250mL/min oxygen were more likely to have a respiratory related admission before two years chronologic age. Conclusion:  Shorter initial NICU stay was the best predictor of earlier home oxygen cessation.  At NICU discharge, infants with hypercarbia or a higher CGA may require more home oxygen and experience more respiratory related hospital admission in the first two years of chronological age.

This a preprint and has not been peer reviewed. Data may be preliminary.

Introduction Approximately 30% of otherwise healthy children will have residual obstructive sleep apnoea (OSA) after first line therapy with adenotonsillectomy (AT) with lower success rates in children with risk factors. Continuous positive airway pressure (CPAP) is often the next treatment option and, whilst highly effective therapy, can be challenging to sustain in children. A pilot study is underway at our centre to evaluate the efficacy of heated humidified high flow nasal cannula therapy (HFNC) compared to CPAP in children with residual OSA. A secondary aim of this study is to determine which therapy (HFNC versus CPAP) the patients prefer. This abstract will report preliminary findings. Methods Children under 18 years old identified as requiring a CPAP trial for residual OSA management were invited to undergo an additional polysomnography, where they underwent a trial of HFNC overnight, which was undertaken in a similar manner to the CPAP trial. Participants and caregivers completed a questionnaire regarding comfort level following both the HFNC and CPAP titration nights. Results 11 participants (4 males) between 4 months and 15 years old have completed the study to date. Using an 11-point Likert scale, the average reported comfort level grading for HFNC was 1.5 points higher than CPAP. Discussion This preliminary data suggests that on average caregivers and participants found HFNC more comfortable than CPAP. Alternative therapies such as HFNC may be effective in managing OSA and may be better tolerated in children non-adherent to CPAP.