Home Oxygen Therapy for Children. An Official American Thoracic Society Clinical Practice Guideline

Area of Science:

• Pediatric Pulmonology
• Clinical Practice Guidelines
• Respiratory Medicine

Background:

• Home oxygen therapy is a common requirement for pediatric patients with chronic respiratory conditions.
• Existing guidelines for pediatric home oxygen therapy are scarce.
• This document focuses on the pediatric population.

Purpose of the Study:

• To provide an evidence-based clinical practice guideline for home oxygen therapy in children.
• To outline recommendations for the implementation, monitoring, and discontinuation of this therapy.
• To address the management of pediatric lung and pulmonary vascular diseases requiring oxygen support.

Main Methods:

• A multidisciplinary panel convened to address key questions on pediatric home oxygen therapy.
• Systematic literature reviews were conducted to gather relevant evidence.
• The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to assess evidence quality and recommendation strength.

Main Results:

• Recommendations were developed based on the panel's confidence in estimated effects, benefit-harm balance, patient values, cost, and feasibility.
• Specific recommendations address the use of home oxygen therapy for pediatric lung and pulmonary vascular diseases.
• The guideline acknowledges the limited empirical evidence base.

Conclusions:

• There is a significant lack of empirical evidence for the implementation, monitoring, and discontinuation of home oxygen therapy in children.
• Clinical recommendations were formulated using limited evidence, expert opinion, and clinical experience.
• The guideline aims to assist clinicians in managing pediatric patients requiring home oxygen and highlights areas for future research.