Managing established bronchopulmonary dysplasia without using routine blood gas measurements

Matthew J Kielt; Laurie C Eldredge; Edward G Shepherd; Robert J DiGeronimo; Audrey N Miller; Roopali Bapat; George El-Ferzli; Stephen E Welty; Leif D Nelin

doi:10.1038/s41372-024-01955-x

Managing established bronchopulmonary dysplasia without using routine blood gas measurements

J Perinatol. 2024 Apr 23. doi: 10.1038/s41372-024-01955-x. Online ahead of print.

Authors

Matthew J Kielt¹, Laurie C Eldredge², Edward G Shepherd¹, Robert J DiGeronimo², Audrey N Miller¹, Roopali Bapat¹, George El-Ferzli¹, Stephen E Welty², Leif D Nelin³

Affiliations

¹ Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital and Department of Pediatrics, The Ohio State University, Columbus, OH, USA.
² The BPD Program at Seattle Children's Hospital and the Department of Pediatrics, University of Washington, Seattle, WA, USA.
³ Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital and Department of Pediatrics, The Ohio State University, Columbus, OH, USA. Leif.Nelin@nationwidechildrens.org.

PMID: 38654082
DOI: 10.1038/s41372-024-01955-x

Abstract

Objective: Routine blood gas measurements are common in infants with severe bronchopulmonary dysplasia (sBPD) and are a noxious stimulus. We developed a guideline-driven approach to evaluate the care of infants with sBPD without routine blood gas sampling in the chronic phase of NICU care (after diagnosis at 36 weeks PMA).

Study design: We examined blood gas utilization and outcomes in our sBPD inpatient care unit using data collected between 2014 and 2020.

Results: 485 sBPD infants met inclusion criteria, and 303 (62%) never had a blood gas obtained after 36 weeks PMA. In infants who had blood gas measurements, the median number of total blood gases per patient was only 4 (IQR 1-10). We did not identify adverse effects on hospital outcomes in patients without routine blood gas measurements.

Conclusions: We found that patients with established BPD could be managed without routine blood gas analyses after 36 weeks PMA.