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Nasopharyngeal oxygen in children
F Shann1, S Gatchalian, R Hutchinson
1Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia.
Insights
Hypoxia in children can be treated effectively with low-flow nasopharyngeal oxygen. This method ensures efficient oxygen use, crucial for treating pneumonia and bronchiolitis in developing nations.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Global Health
Background:
- Hypoxia due to pneumonia or bronchiolitis is a leading cause of mortality in children in developing countries.
- Oxygen therapy is vital but often limited and expensive in these regions, necessitating efficient administration methods.
Purpose of the Study:
- To evaluate the efficacy and appropriate flow rates of nasopharyngeal oxygen administration in infants and young children.
- To determine a cost-effective method for delivering supplemental oxygen to pediatric patients with respiratory distress.
Main Methods:
- Oxygen was delivered via an 8 French gauge (FG) catheter inserted nasopharyngeally to a specific depth.
- Flow rates were adjusted based on patient weight, with a target of 150 ml/kg/min.
- Inspired oxygen concentration was measured in children under two years old.
Main Results:
- A flow rate of 150 ml/kg/min achieved an inspired oxygen concentration of approximately 50% in children under two years old.
- Newborn infants with pneumonia typically required 0.5 L/min of nasopharyngeal oxygen.
- Infants up to 12 months old required approximately 1.0 L/min of nasopharyngeal oxygen.
Conclusions:
- Nasopharyngeal oxygen administration is an effective and efficient method for treating hypoxia in young children.
- Specific, low flow rates can provide adequate oxygenation for infants and children with pneumonia or bronchiolitis in resource-limited settings.
- This technique offers a practical solution for optimizing oxygen use in developing countries.
Abstract:
Hypoxia caused by pneumonia or bronchiolitis is a common cause of death in children in developing countries. Oxygen is very expensive in developing countries, and it is important that the limited supplies available be used as efficiently as possible. This study evaluated the administration of oxygen through an 8 FG catheter inserted into the nose to a depth equal to the distance from the side of the nose to the front of the ear, so that the tip of the catheter was just visible in the pharynx below the soft palate. A flow rate of 150 ml/kg/min gave an inspired oxygen concentration of about 50% in children less than 2 years old. Thus, newborn infants with pneumonia can usually be treated with 0.5 l/min and infants up to 12 months old with 1.0 l/min of nasopharyngeal oxygen.