Room air challenge predicts duration of supplemental respiratory support for infants with bronchopulmonary dysplasia

OBJECTIVE: To determine whether a room air challenge (RAC) correlates with duration of respiratory support for infants with bronchopulmonary dysplasia (BPD). STUDY DESIGN: Prospective study of preterm infants with BPD from 2015–2018. Infants receiving ≤2 liters flow at 36 weeks post-menstrual age (PMA) underwent RAC. Cox regression was used to adjust the duration of respiratory support after 36 weeks PMA for significant covariates. RESULTS: Of 161 infants with BPD, 91 were eligible for RAC; 51 passed and 40 failed. Infants who failed RAC had longer respiratory support after 36 weeks PMA than infants who passed (median 19 weeks (IQR 15–33) versus 2 weeks (IQR 1–8, p<0.001)), which persisted after multivariable adjustment (hazard ratio −1.42, 95% CI −1.94 to −0.91, p<0.001). Infants failing RAC also had more frequent and longer duration of home oxygen use. CONCLUSION: RAC may help provide anticipatory guidance regarding duration of respiratory support for infants with BPD.