Oxigenoterapia domiciliaria en niños con insuficiencia respiratoria crónica / Home oxygen therapy in children with chronic respiratory failure

ABSTRACT

Background: Home oxygen therapy improves survival and quality of the life in adults with chronic obstructive airwais disease. The few studies about home oxigen therapy in children show improvements in weight gain, school performance and decreasesin hospitalization expenses. Aim: To report our experience in home oxygen therapy in children followed for six month to four years. Patients and methods: Fifty five children, less than 15 years old, discharged from a University hospital with the diagnosis of chronic respiratory failure, were followed for up at their homes. Results: Dicharge diagnoses were bronchopulmonary dysplasia in 36 percent of children, postinfectious pulmonary damage in 22 percent, neonatal distress in 13 percent, chronic aspiration in 9 percent, cystic fibrosis in 7 percent and miscellaneous in 13 percent. Forty six completed at least 6 months of follow up, five moved to other hospitals, three required ventilatory support and one died. Oxygen was discontinued in 33 patients, and this occurred before the ninth month of follow up in 88percent of those children. Neonatal distress and bronchopulmonary dysplasia had the best prognoses, and oxygen was discontinued at 4ñ1 and 5.7ñ3 months respectively. Patients with postinfectious pulmonary disease had a higher incidence of bronchoneumoniae, and those with bronchopulmonary dysplasia a higher incidence of acute bronchiolitis, that motivated hospital admissions. Expenses due to home oxygen were lower than hospitalization costs. No adverse effects were detected. Conclusions: Infants and newborns on home oxygen therapy have a good prognosis, specially those with reversible diseases. this type of therapy allows an earlier hospital discharge with considerable cost reductions