Creating a clinical practice guideline for home oxygen therapy for children
Although home oxygen therapy is commonly required to care for children with respiratory conditions, there is a striking lack of empirical evidence regarding implementation, monitoring and discontinuation of supplemental oxygen therapy. In some cases, insurance companies and durable medical equipment suppliers apply adult standards for oxygen use that are unsafe for kids. Children and infants have specialized needs for their growing brains and bodies, and their respiratory care should be treated differently than adults.
Robin Deterding, MD, senior author and co-chair of the subcommittee that authored this research, and Don Hayes Jr., MD at Nationwide Children’s and co-chair of the committee, worked together to identify the challenges with home oxygen therapy specific to both pediatric lung disease and pulmonary vascular disease. Joyce Baker, clinical coordinator for Respiratory Therapy, Steven H. Abman, MD, and Stephen Hawkins, MD, from the Breathing Institute at Children’s Colorado participated as members of a multidisciplinary panel and conducted systematic reviews of relevant literature to set a new standard of care for oxygen use in children. Based on this review, the panel developed an official clinical practice guideline featuring recommendations for or against the use of home oxygen therapy based on each condition.
Read the article “Home Oxygen Therapy for Children. An Official American Thoracic Society Clinical Practice Guideline.”
Early Pulmonary Vascular Disease in Preterm Infants Is Associated with Late Respiratory Outcomes in Childhood
Despite marked advances in perinatal care, preterm infants remain at high risk for chronic lung disease, known as bronchopulmonary dysplasia (BPD). BPD is often associated with poor outcomes, such as prolonged ventilator support, lengthy NICU stays, persistent respiratory failure and late respiratory disease during early childhood. Past experimental work from the Pediatric Heart Lung Center (PHLC) showed that the development of pulmonary vascular disease (PVD) during the perinatal period causes high risk for BPD and for pulmonary hypertension (PH) in rodents. This prospective study, featuring several providers from Children’s Colorado, confirmed this concept in human infants. Researchers determined that early signs of PVD in preterm neonates on day 7 of life increased the susceptibility for BPD as well as late breathing problems, such as frequent ER visits, rehospitalizations and the need for respiratory medications throughout the first 2 years of life. These data further suggest that identifying PVD in preterm infants at day 7 may allow future interventions to prevent late lung disease after preterm birth.
Read the article “Early Pulmonary Vascular Disease in Preterm Infants Is Associated with Late Respiratory Outcomes in Childhood.”