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Original research
Retrospective analysis of referrals for hypoxic challenge testing in children born preterm
  1. Anna Howells1,
  2. Mollie Riley2,
  3. Martin Samuels2,
  4. Paul Aurora3
  1. 1 Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  2. 2 Department of Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  3. 3 Respiratory, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  1. Correspondence to Dr Anna Howells, Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK; anna.howells3{at}nhs.net

Abstract

Introduction Children with a history of bronchopulmonary dysplasia (BPD) may be at risk of hypoxaemia at altitude, such as during air travel. We have performed preflight hypoxic challenge testing (HCT) since 2006, incorporating British Thoracic Society (BTS) guidance since 2011, to determine which children may require oxygen during air travel.

Aims We aimed to compare the outcome of HCTs in children with a history of BPD who met the 2011 BTS criteria and those who did not and, in addition to this, to interrogate the data for factors that may predict the outcome of HCT in this population.

Methods We performed a retrospective analysis of data from HCTs of children with a history of BPD referred 2006–2020. Cases were excluded if the patient had a respiratory comorbidity, was still on oxygen therapy, if the test was a repeat or if the clinical record was incomplete. Descriptive and univariate analysis of the data was performed, and a binary logistic regression model was fitted.

Results There were 79 HCTs, of which 24/79 (30%) did not meet BTS 2011 guidelines referral criteria. The analysis showed a greater proportion of desaturation in the group that did not meet criteria: 46% vs 27% (no statistical significance). Baseline oxygen saturations were higher in those who did not require oxygen during HCT and this variable was significant when adjusted for confounders.

Conclusions This study found that the current criteria for referral for preflight testing may incorrectly identify those most at risk and highlights the need for further investigation to ensure those most at risk are being assessed prior to air travel.

  • Child
  • Infant, Newborn
  • Altitude
  • Bronchopulmonary Dysplasia
  • Referral and Consultation

Data availability statement

Data are available upon reasonable request. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Data availability statement

Data are available upon reasonable request. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Footnotes

  • Correction notice This article has been corrected since it was published Online First. A typo has been corrected in the abstract.

  • Contributors AH analysed the data, wrote and edited the manuscript and approved the final version. MR edited the manuscript. MS and PA supervised the data analysis, edited the manuscript and approved the final version. MS acts as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.