Pediatric Patients With Oxygen in the Acute Care Setting

Publication Date: July 1, 2021
Last Updated: March 14, 2022

1. In hospitalized pediatric patients, does the use of oxygen tents and hoods vs low-flow oxygen systems (eg, nasal cannula, simple face mask) provide a more consistent oxygen delivery?

The committee does not recommend using an oxygen hood or tent in lieu of a low-flow oxygen device for consistent oxygen delivery.

(C)
(Median appropriateness score 8)
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2. In hospitalized pediatric patients, does the use of high-flow oxygen systems vs low-flow oxygen systems increase the FDO2 or decrease escalation of therapy (noninvasive ventilation or intubation)?

The use of HFNC appears to be safe and more effective than low-flow oxygen to treat infants with moderate to severe bronchiolitis in the pediatric ward and pediatric ICU settings.

(B)
(Median appropriateness score 7.5)
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3. In hospitalized pediatric patients, does adding active or passive humidification to supplemental oxygen as compared to no humidification improve comfort or reduce infection risk?

Low level of evidence does not support the use of heated or non-heated humidification with low-flow oxygen delivery.

(B)
(Median appropriateness score 8.25)
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4. In hospitalized pediatric patients, does establishing disease-specific oxygenation targets reduce oxygen use, decrease length of stay, or prevent escalation of therapy as compared to prescribed or no disease-specific oxygen targets?

  • In hospitalized pediatric patients suffering from bronchiolitis, evidence supports an oxygenation target of 90% or greater.
(C)
(Median appropriateness score 7)
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  • In hospitalized pediatric patients suffering from respiratory diseases outside of bronchiolitis, establishing a patient/disease oxygen therapy target upon admission is best practice, but a specific target cannot be recommended.
(C)
(Median appropriateness score 7)
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Recommendation Grading

Overview

Title

Management of Pediatric Patients With Oxygen in the Acute Care Setting

Authoring Organization

Publication Month/Year

July 1, 2021

Last Updated Month/Year

August 14, 2023

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Male, Female, Child, Infant

Health Care Settings

Ambulatory, Childcare center, Emergency care

Intended Users

Nurse, nurse midwife, nurse practitioner, physician, physician assistant

Scope

Management

Diseases/Conditions (MeSH)

D015278 - Intensive Care Units, Pediatric, D010100 - Oxygen

Keywords

hypoxemia, pediatric, infant, child, oxygen, Clinical Practice Guideline, cardiopulmonary disease

Source Citation

Napolitano N, Berlinski A, Walsh BK, Ginier E, Strickland SL. AARC Clinical Practice Guideline: Management of Pediatric Patients With Oxygen in the Acute Care Setting. Respir Care. 2021 Jul;66(7):1214-1223. doi: 10.4187/respcare.09006. Epub 2021 Mar 31. PMID: 33790048.

Supplemental Methodology Resources

Data Supplement