The American Thoracic Society (ATS) has published new guidelines for the use of home oxygen therapy in children with chronic respiratory conditions.
For the development of the guidelines, a multidisciplinary panel created a series of questions regarding home oxygen therapy in children and conducted systematic reviews of available, relevant literature. Evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation approach.
Among the recommendations:
Home oxygen therapy should be prescribed for patients with cystic fibrosis complicated by severe chronic hypoxemia, bronchopulmonary dysplasia complicated by chronic hypoxemia, sleep-disordered breathing complicated by severe nocturnal hypoxemia who cannot tolerate positive airway pressure therapy, sickle cell disease complicated by severe chronic hypoxemia, and those with interstitial lung disease complicated by severe chronic hypoxemia.
Home oxygen should not be used in patients with pulmonary hypertension and congenital heart disease.
“Despite widespread use of home oxygen therapy in children for various lung and pulmonary vascular diseases, there is a striking paucity of data regarding its implementation, efficacy, monitoring, and discontinuation. With limited evidence, the panel provides recommendations based on expert opinion and experiences associated with patient-important outcomes that will aid clinicians in the management of complex pediatric patients requiring home oxygen therapy. Future research should address important areas including SpO2 levels associated with optimal growth and development and the identification of best practice for weaning and discontinuing home oxygen therapy in children.
The target audience for this guideline, according to the ATS, includes This group includes pediatric pulmonologists, pediatric cardiologists, neonatologists, general pediatricians and family practitioners, emergency medicine and primary care clinicians, other healthcare professionals, and policy makers.
Hayes D, Wilson KC, Krivchenia K, et al. Home oxygen therapy for children. An official American Thoracic Society clinical practice guideline [published online February 1, 2019]. Am J Respir Crit Care Med. https://doi.org/10.1164/rccm.201812-2276ST