Home Oxygen Therapy Utilization in a Newborn Intensive Care Unit Population at Altitude

Neonates born at higher altitudes may be at increased risk for adverse outcomes due to lower ambient oxygen availability. Despite frequent use of home oxygen therapy following neonatal intensive care unit (NICU) discharge, evidence-based guidelines assessing discharge readiness and oxygen prescribing in high-altitude settings remains limited. This study aimed to identify factors associated with adverse events following discharge and characterize infants discharged with home oxygen therapy in New Mexico. A retrospective chart review was conducted of infants discharged with home oxygen therapy from the University of New Mexico Hospital (UNMH) NICU from 1 July 2018 through 1 July 2023. We found that lower room air trial oxygen saturation and lower birth weight were both significantly associated with adverse events after discharge. These findings informed implementation institutional discharge protocols that indicated minimum room air saturation thresholds prior to discharge and oxygen adjustments for higher altitude. Although implementation of these protocols was not associated with a statistically significant reduction in adverse events, this work established a foundation for future multicenter collaboration with other centers at high altitude to validate these findings and further refine evidence-based discharge practices for infants living at high altitude.