OP-026 Feasibility, safety, efficacy, utility of at-home O2-therapy for bronchiolitis

AimLow respiratory tract infections is a leading cause of hospitalization, related to acute bronchiolitis (AB) and acute/subacute asthma (AA), and to mainly RSV/hRV-infections. Nutritional impairment and hypoxemia are the main indication for admission, and prolonged need for oxygen may lengthen the...

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Published in:BMJ paediatrics open 2024-07, Vol.8 (Suppl 5), p.A11-A12
Main Authors: Tossavi, Agodomou, Amandine, Gaudin, Sabine, Finci, Aude, Peralta, Come, Horvat, Chadia, Toumi, Tom, Toin, Elsa, Masson, Luc, Penetta, Antoine, Ouziel, Matthieu, Receveur, Ellia, Mezgueldi, Sophie, Delorme, Angélique, Suze, Sophie, Collot, Philippe, Cheyssac, Carine, Chassery, Aymeric, Cantais, Elise, Launay, Cécile, Guiheneuf, Etienne, Javouhey, Julie, Haesebaert, Jean-Sebastien, Casalegno, Yves, Gillet, Dominique, Ploin
Format: Article
Language:English
Subjects:
Healthcare organization
Home health care
Hospital at home
Low respiratory tract infection/hypoxemia
Lung diseases
Oral Presentation
Oxygen therapy
Patient safety
Pediatric emergency department
Pediatrics
Young children
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Summary:AimLow respiratory tract infections is a leading cause of hospitalization, related to acute bronchiolitis (AB) and acute/subacute asthma (AA), and to mainly RSV/hRV-infections. Nutritional impairment and hypoxemia are the main indication for admission, and prolonged need for oxygen may lengthen the stay. We initiated a hospital-at-home (HAH) protocol for children in the steady-state prolonged low-flow oxygenotherapy phase (SS-LF-O2HAHP). Our retrospective study aimed to assess the feasibility, safety, acceptability, and utility of SS-LF-O2HAHP during 2022–2023 winter.Material and MethodInclusion criteria: stable AB/AA after ≥24h monitoring, need of ≤1 lO2/min. Exclusion criteria: toxic aspect, fever, apnea, diarrhea, parental psychosocial difficulties, parental refusal, child’s home out of HAH intervention area. During the HAH, nurse contacts were daily. A HAH-nurse was available by phone 24/7 for parents, and a HAH-physician was available 24/7 by phone for the nurses. The outcomes were: The percentage of HAH-setups, the number of days of HAH-stay, the number of hospital readmission after HAH-discharge, the number of serious/non-serious adverse event (SAE/AE), and parental satisfaction.ResultsParental refusal led to 3 exclusions, 38 children were included (23 with AB and 15 with AA) and all had HAH-setup. SAE arose twice (5%): readmission in conventional departments: 1 with AB (new viral infection), 1 with AA (development of bronchiolitis obliterans). AE arose 5 times (21%): 4 O2-delivery failures (issue solved on the same day); 1 patient had an otitis media. Out of 12 satisfaction surveys, 100% of parents expressed complete satisfaction overall; 3 (8%) were not completely satisfied with the device (O2 delivery failure).ConclusionsThe SS-LF-O2HAHP appeared feasible, safe, with high parental satisfaction. During the pilot phase, the capacity was limited to 1 child per open day; 332 saved days of hospital stay indicates high utility. Applying this model on a larger scale can create challenges in recruiting and managing the team of healthcare professionals.
ISSN:2399-9772
DOI:10.1136/bmjpo-2024-EPAC.26