Abstract
Background: High flow oxygen therapy (HFOT) has been increasingly used for the treatment of hypoxemic and hypercapnic respiratory insufficiency in children with chronic lung disease of prematurity (CLD). Data on chronic home treatment with this modality are scarce.
Objective: Evaluation of feasibility and safety of home HFOT for ex-premature children with respiratory insufficiency needing long term respiratory support.
Methods: Retrospective medical file analysis of children discharged home on chronic respiratory support during 2014 and 2015 treated at the University Children's Hospital Ljubljana.
Results: 3 children (1 girl) with CLD were discharged home on HFOT during the observation period. Their mean gestational age at birth was 28 (±3.8) weeks. At 36 weeks gestation they were all CPAP and oxygen dependent. Mean chronologic age at HFOT initiation was 97 (±47) days. Decision to start HFOT was based on suboptimal condition after CPAP withdrawal defined as: (1) FiO2>30% for target SpO2 91-94%, (2) worsening tachypnea with pronounced work of breathing and (3) inadequate or poor feeding. Children were adapted and family members educated to Fisher&Paykel AirvoTM 2 and discharged home 19(±8) days after initiation, on mean FiO2 33%(±2), flow 6.0(±0.5) l/min., PaCO2 7.8(±0.4) kPa. Patents were followed with regular in-hospital overnight respiratory polygraphies. The mean duration of home treatment (2 children) was 108(±14) days, one child still on treatment. No one needed re hospitalization due to respiratory deterioration on HFOT.
Conclusions: Home HFOT can be safely and efficiently used in children with severe CLD needing low level respiratory support for optimal growth and development outside the medical facilities.
- Copyright ©the authors 2016
