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

key information

source: American Journal of Respiratory and Critical Care Medicine

year: 2019

authors: Hayes D Jr, Wilson KC, Krivchenia K, Hawkins SMM, Balfour-Lynn IM, Gozal D, Panitch HB, Splaingard ML, Rhein LM, Kurland G, Abman SH, Hoffman TM, Carroll CL, Cataletto ME, Tumin D, Oren E, Martin RJ, Baker J, Porta GR, Kaley D, Gettys A, Deterding RR

summary/abstract:

Background:
Home oxygen therapy is often required in children with chronic respiratory conditions. This document provides an evidence-based clinical practice guideline on the implementation, monitoring, and discontinuation of home oxygen therapy for the pediatric population.

Methods:
A multidisciplinary panel identified pertinent questions regarding home oxygen therapy in children, conducted systematic reviews of the relevant literature, and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach to rate the quality of evidence and strength of clinical recommendations.

Results:
After considering the panel’s confidence in the estimated effects, the balance of desirable (benefits) and undesirable (harms and burdens) consequences of treatment, patient values and preferences, cost, and feasibility, recommendations were developed for or against home oxygen therapy specific to pediatric lung and pulmonary vascular diseases.

Conclusions:
Although home oxygen therapy is commonly required in the care of children, there is a striking lack of empirical evidence regarding implementation, monitoring, and discontinuation of supplemental oxygen therapy. The panel formulated and provided the rationale for clinical recommendations for home oxygen therapy based on scant empirical evidence, expert opinion, and clinical experience to aid clinicians in the management of these complex pediatric patients and identified important areas for future research.

organization: Nationwide Children’s Hospital, USA; Children’s Hospital Colorado, USA; Royal Brompton Hospital, UK; Connecticut Children’s Medical Center, USA; Stony Brook University School of Medicine, USA; University of Missouri School of Medicine, USA; University of North Carolina School of Medicine, USA; Lucile Packard Children’s Hospital at Stanford, USA; Children’s Hospital of Pittsburgh, USA; Case Western Reserve University School of Medicine, USA; San Diego State University School of Public Health, USA; Children’s Hospital of Philadelphia, USA; Children’s Interstitial Lung Disease Foundation Inc., USA; University of Massachusetts Medical School, USA; Boston University School of Medicine, USA; American Thoracic Society, USA

DOI: 10.1164/rccm.201812-2276ST

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