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DIFFERENTIAL OXYGENATION INDEX TRAJECTORIES FOR BRONCHOPULMONARY DYSPLASIA OF VARIOUS GRADES IN INFANTS BORN LESS THAN 32 WEEKS’ GESTATION
- Srinandini S. Rao (United States of America)
Abstract
Background and Aims
Bronchopulmonary dysplasia (BPD) remains a significant challenge. Distinct patterns of fraction of inspired oxygen trajectories (FiO2) early in life has been shown to correlate with BPD, but FiO2 did not capture full respiratory status. Our aim was to assess whether the oxygenation index (OI) trajectories during early postnatal life were distinct among various BPD grades.
Methods
A single-center retrospective study with data from babies born at less than 32 weeks' gestation between 2018 and 2020 for OI calculation and BPD grading were performed. Given non-linear trajectory patterns of OI, we utilized the generalized additive mixed modeling (GAMM) technique for modeling. OI values were log-transformed prior to modeling for better normal distribution approximation. Patient-specific intercepts and slopes were allowed. An interaction term to account for BPD grades was introduced. The differences in expected OI trajectories between grades were then calculated.
Results
Table 1 contains demographic summary. Expected trajectories of log-transformed OI for each BPD grade and their differences between grades are shown in Figure 1 and 2, respectively. The results showed higher expected OI trajectories in all BPD grade groups compared to the no-BPD group (Grade 0) during the 1st week of life. Moreover, the distinctions in the expected OI trajectories among Grade 1-3 became apparent after 14 days of life.
Table 1:
Figure 1:
Figure 2:
Conclusions
OI trajectories differ among BPD grades in early postnatal life. OI trajectories in the first three weeks of life may be used to predict BPD grades and to guide therapeutic interventions.