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[Home oxygen therapy in children with chronic respiratory failure]
P Bertrand1, C Alvarez, J Fabres
1Departamento de Pediatría, Pontificia Universidad Católica de Chile, Santiago, Chile.
Insights
Home oxygen therapy for children with chronic respiratory failure leads to good prognoses, especially for reversible conditions. This treatment enables earlier hospital discharge and significant cost savings.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Home Healthcare
Context:
- Home oxygen therapy (HOT) is established for adults with chronic obstructive airways disease.
- Limited data exists on HOT's efficacy and safety in pediatric populations.
- Previous studies suggest benefits like improved weight gain and reduced hospitalizations in children.
Purpose:
- To evaluate the experience and outcomes of home oxygen therapy in children.
- To assess the duration of therapy and associated diagnoses.
- To analyze cost-effectiveness and adverse events in pediatric HOT.
Summary:
- Fifty-five children under 15 with chronic respiratory failure received home oxygen therapy.
- Common diagnoses included bronchopulmonary dysplasia, postinfectious pulmonary damage, and neonatal distress.
- Oxygen was discontinued in 33 patients, most before nine months, with good prognoses for neonatal distress and bronchopulmonary dysplasia.
Impact:
- Home oxygen therapy in infants and newborns demonstrates a favorable prognosis, particularly for reversible conditions.
- Facilitates earlier hospital discharge for pediatric patients.
- Offers considerable cost reductions compared to prolonged hospitalization.
Background:
Home oxygen therapy improves survival and quality of life in adults with chronic obstructive airways disease. The few studies about home oxygen therapy in children show improvements in weight gain, school performance and decreases in hospitalization expenses.
Aim:
To report our experience in home oxygen therapy in children followed for six months to four years.
Patients And Methods:
Fifty five children, less than 15 years old, discharged from a University hospital with the diagnosis of chronic respiratory failure, were followed up at their homes.
Results:
Discharge diagnoses were bronchopulmonary dysplasia in 36% of children, postinfectious pulmonary damage in 22%, neonatal distress in 13%, chronic aspiration in 9%, cystic fibrosis in 7% and miscellaneous in 13%. Forty six completed at least 6 months of follow up, five moved to other hospitals, three required ventilatory support and one died. Oxygen was discontinued in 33 patients, and this occurred before the ninth month of follow up in 88% of those children. Neonatal distress and bronchopulmonary dysplasia had the best prognoses, and oxygen was discontinued at 4 +/- 1 and 5.7 +/- 3 months respectively. Patients with postinfectious pulmonary disease had a higher incidence of bronchoneumoniae, and those with bronchopulmonary dysplasia a higher incidence of acute bronchiolitis, that motivated hospital admissions. Expenses due to home oxygen were lower than hospitalization costs. No adverse effects were detected.
Conclusions:
Infants and newborns on home oxygen therapy have a good prognosis, specially those with reversible diseases. This type of therapy allows an earlier hospital discharge with considerable cost reductions.