Pediatric Patients With Oxygen in the Acute Care Setting
1. In hospitalized pediatric patients, does the use of oxygen tents and hoods vs low-flow oxygen systems (eg, nasal cannula, simple face mask) provide a more consistent oxygen delivery?
The committee does not recommend using an oxygen hood or tent in lieu of a low-flow oxygen device for consistent oxygen delivery.
(C)2. In hospitalized pediatric patients, does the use of high-flow oxygen systems vs low-flow oxygen systems increase the FDO2 or decrease escalation of therapy (noninvasive ventilation or intubation)?
The use of HFNC appears to be safe and more effective than low-flow oxygen to treat infants with moderate to severe bronchiolitis in the pediatric ward and pediatric ICU settings.
(B)3. In hospitalized pediatric patients, does adding active or passive humidification to supplemental oxygen as compared to no humidification improve comfort or reduce infection risk?
Low level of evidence does not support the use of heated or non-heated humidification with low-flow oxygen delivery.
(B)4. In hospitalized pediatric patients, does establishing disease-specific oxygenation targets reduce oxygen use, decrease length of stay, or prevent escalation of therapy as compared to prescribed or no disease-specific oxygen targets?
- In hospitalized pediatric patients suffering from bronchiolitis, evidence supports an oxygenation target of 90% or greater.
- In hospitalized pediatric patients suffering from respiratory diseases outside of bronchiolitis, establishing a patient/disease oxygen therapy target upon admission is best practice, but a specific target cannot be recommended.
Recommendation Grading
Overview
Title
Management of Pediatric Patients With Oxygen in the Acute Care Setting
Authoring Organization
American Association for Respiratory Care
Publication Month/Year
June 30, 2021
Last Updated Month/Year
August 30, 2024
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Male, Female, Child, Infant
Health Care Settings
Ambulatory, Childcare center, Emergency care
Intended Users
Nurse, nurse midwife, nurse practitioner, physician, physician assistant
Scope
Management
Diseases/Conditions (MeSH)
D015278 - Intensive Care Units, Pediatric, D010100 - Oxygen
Keywords
hypoxemia, pediatric, infant, child, oxygen, Clinical Practice Guideline, cardiopulmonary disease
Source Citation
Napolitano N, Berlinski A, Walsh BK, Ginier E, Strickland SL. AARC Clinical Practice Guideline: Management of Pediatric Patients With Oxygen in the Acute Care Setting. Respir Care. 2021 Jul;66(7):1214-1223. doi: 10.4187/respcare.09006. Epub 2021 Mar 31. PMID: 33790048.