Stress Oximetry: Description of a Test to Determine Readiness for Discontinuing Oxygen Therapy in Infants with Chronic Lung Disease

BACKGROUND: In infants with CLD there are no objective tests to monitor an infant's progress towards weaning out of oxygen inhalation therapy (O(2)IT). A test involving staged maneuvers of increasing respiratory stress while decreasing oxygen support, termed Stress Oximetry (StressOx), has been used at our center for weaning O(2)IT. OBJECTIVE: To report the clinical utility of “StressOx” in evaluating readiness for discontinuing O(2)IT in infants with CLD. METHODS: A retrospective review was done of StressOx tests administered at our center from 2002-2008. StressOx was performed based on a consistent clinical protocol in all eligible infants on O(2)IT. O(2)IT was generally discontinued after infant had passed two StressOx tests and subsequently infants were monitored for a minimum of 7 days to determine successful weaning. RESULTS: There were 279 infants with 899 tests that met inclusion criteria. An average of 3 tests per infant was done, one week apart. The test had a specificity of 97.4% and a positive predictive value of 99.6% in determining success of discontinuing O(2)IT. CONCLUSIONS: StressOx appears to be a clinically useful test that may help in determining an infant's ability to successfully wean out of O(2)IT. Further validation of this test is warranted.