Home oxygen therapy for bronchiolitis well-accepted by parents and caregivers: AAP

Inclusion criteria were met by ten studies, all for home oxygen therapy. One abstract on nasogastric feeding did not fulfill full inclusion criteria.

The study yielded the following findings:

• The researchers found no studies on remote monitoring.
• Both at altitude and sea level, HOT appears feasible in terms of uptake (70%–82%) and successful completion.
• Two qualitative studies reported caregiver acceptability.
• There were seven reported adverse events (0.6%) with 0 mortality in 1257 patients.
• Cost studies showed savings, although they included costs to hospitals only.

The study, however, was limited by the presence of a small number of studies with heterogenous study design and quality and the absence of adequately powered randomized control studies.

"Evidence that supports the feasibility and safety of managing oxygen requirements for bronchiolitis in the home exists, particularly in areas of high altitude," the researchers wrote. "For a better understanding of HAH's role in bronchiolitis management, further studies are needed at sea level."

More studies are required to examine the cost-effectiveness by including costs to society of oxygen therapy and exploring health care systems outside of the US to determine alternate strategies to reduce inpatient durations. And to examine the feasibility and safety of models of care to support other care needs such as observation of those at deterioration risk and NGT feeding.

Reference:

Joanna Lawrence, Ramesh Walpola, Suzanne L. Boyce, Penelope A. Bryant, Anurag Sharma, Harriet Hiscock; Home Care for Bronchiolitis: a Systematic Review. Pediatrics 2022; e2022056603. 10.1542/peds.2022-056603