TOP 5 - Updated Guideline for Home Oxygen Therapy Utilization in a Newborn Intensive Care Population at Altitude

Publication Number: 3779.TOP 5

Joshua Reddish, University of New Mexico School of Medicine, Albuquerque, NM, United States; Jessie Maxwell, University of New Mexico School of Medicine, Albuquerque, NM, United States; Jessica M. Gross, University of New Mexico, Albuquerque, NM, United States; Alyssa Aragon, University of New Mexico School of Medicine, Albuquerque, NM, United States; Daniella Rodriguez, University of New Mexico School of Medicine, Albuquerque, NM, United States

Background: Infants have a lower average oxygen saturation and more desaturation events at high altitude compared to sea level. This often necessitates discharging many infants at high altitude with home oxygen therapy. There is limited guidance on safely providing home oxygen to this high-risk population. Most children in New Mexico reside at altitudes above 4,000 feet, making the University of New Mexico Hospital (UNMH) Newborn Intensive Care Unit (NICU) an ideal location to further investigate this situation.

Objective: The objective of this study is to determine risk factors for adverse events (injury or healthcare utilization related to the participant’s respiratory status) related to home oxygen therapy in infants discharged from a NICU at high altitude. This information was used to create a new protocol for home oxygen therapy, with prospective data collection following implementation.

Design/Methods: A retrospective chart review was performed on infants who required home oxygen therapy from July 1, 2018 through July 1, 2023 after discharge from the UNMH NICU. Information including sex, birth weight, gestational age, race, and ethnicity were collected. The room air saturation prior to discharge was recorded, as well as any known adverse events following hospital discharge. Logistical regression showed a room air saturation less than 78% prior to discharge and decreasing birth weight were predictive of adverse events after discharge (p’s < 0.05). A new protocol with a requirement for a room air saturation ≥80% without oxygen in place was implemented May 1, 2025, with the discharge oxygen flow rate tailored based on home altitude. Data collection on the impacts of this protocol is ongoing.