Oxygen therapy as part of the treatment for respiratory infections in children

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Oxygen therapy as part of the treatment for respiratory infections in children

Review question
We reviewed the evidence about the beneficial effect of oxygen supplementation as part of the treatment for children with lower respiratory tract infection (LRTI). As oxygen may be administered using different delivery methods, we reviewed the most commonly used methods to deliver oxygen in children. As a secondary question, we reviewed the evidence regarding which signs or symptoms could indicate the need for in children presenting with LRTI.

LRTI is the most frequent cause for hospitalisation out of all respiratory infections and one of the leading causes of and in children aged under five in low-income countries. Oxygen plays an important part in treating severe LRTIs but we need to determine its at preventing children from developing more severe disease. Oxygen can be delivered by non-invasive methods (nasal prongs, nasal , nasopharyngeal , face mask and head box) and we wanted to discover how effective these methods are as they have not been adequately evaluated.

Studies characteristics
For our primary question we included experimental studies assessing the use of oxygen versus no oxygen and studies comparing oxygen delivery systems in children aged from one to five years with LRTI. We identified one pilot (58 children) assessing in children with pneumonia and four studies (479 participants) assessing the of different non-invasive oxygen delivery systems.

For our secondary question, we included 14 observational studies conducted to determine the clinical indicators of in children with LRTIs.

Key results
It appears that given early in the course of pneumonia via nasal prongs at a flow rate of 1 to 2 L/min does not prevent children with severe pneumonia from developing . However, the applicability of this evidence is limited as it comes from a small pilot . Clinicians caring for children must make their decision to use supplemental oxygen on an individual basis.

Nasal prongs and nasopharyngeal are similar in when used for children with LRTI. Nasal prongs are associated with less nasal obstruction. The use of a face mask and head box has been poorly studied and appears not to be superior to nasopharyngeal in terms of or safety when used in children with LRTI.

There is no single clinical sign or symptom that accurately identifies in children with LRTI. However, the summary of results presented here can help clinicians to identify children with more severe conditions.

Studies assessing the of in children with different baseline risks are needed, as well as studies that aim to identify the most effective and safe oxygen delivery method.

Our evidence is current to October 2014.

This record should be cited as: 

Rojas-Reyes M, Granados Rugeles C, Charry-Anzola L. Oxygen therapy for lower respiratory tract infections in children between 3 months and 15 years of age. Cochrane Database of Systematic Reviews 2014, Issue 12. Art. No.: CD005975. DOI: 10.1002/14651858.CD005975.pub3

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