30 Questions
What is the focus of the AARC Clinical Practice Guideline mentioned in the text?
Providing evidence-based clinical practice guidelines for pediatric oxygen therapy
What is the goal of the systematic review conducted in the guideline?
To provide evidence-based clinical practice guidelines for pediatric oxygen therapy
What is highlighted as one of the most important therapeutics in the clinical management of pediatric patients with cardiopulmonary disease?
Oxygen therapy
What aspect of oxygen therapy in pediatric patients is the guideline seeking to address?
Comparison of delivery devices
According to the text, what is the medical community seeking to ensure in the management of clinical interventions?
Evidence-based management
What is the primary focus of the comparison mentioned in the guideline?
Comparison of delivery devices for pediatric oxygen therapy
What software was used to identify and remove duplicate citations?
EndNote X8
How many articles remained after the title and abstract screening?
166
What method was used to combine evidence with the collective experience of committee members?
Modification of the RAND/UCLA Appropriateness Method
What databases were used for the literature search?
PubMed, CINAHL via EBSCOhost, and Scopus.com
What were the inclusion criteria for study eligibility?
Oxygen therapy and pediatric population
How were recommendations assigned evidence levels?
Based on the strength of scientific evidence or collective experience of the committee
What are the disadvantages of oxygen tents mentioned in the text?
Limited maximum FIO2, potential fire hazards, difficulty in setup and maintenance
What is the potential advantage of high-flow nasal cannula (HFNC) over conventional oxygen therapy?
Reduced therapy escalation and treatment failure rates
What is the committee's recommendation regarding the use of oxygen hoods or tents?
Not to use them instead of low-flow oxygen devices for consistent oxygen delivery
What is the potential result of discontinuing supplemental oxygen at a stable 90% SpO2?
Earlier discharge from the hospital
What was the impact of a lower SpO2 target range according to the evidence?
Less time to further supplemental oxygen, fitness to discharge, and overall less time to discharge
What benefit does the evidence suggest high-flow oxygen systems like HFNC may offer in managing pediatric patients with respiratory conditions?
Offer benefits in managing pediatric patients with respiratory conditions
What does the AARC Clinical Practice Guideline recommend for treating infants with moderate to severe bronchiolitis in pediatric ward and ICU settings?
High-flow nasal cannula (HFNC)
What is a potential benefit of using HFNC in pediatric patients?
Washout of nasopharyngeal dead space
What oxygenation target is supported for hospitalized pediatric patients with bronchiolitis?
90% or greater
What is a challenge in analyzing the published data comparing low-flow and HFNC systems in infants and children for respiratory conditions?
Variable definitions of HFNC among publications and small sample sizes
What does the committee not recommend for consistent oxygen delivery in hospitalized pediatric patients?
Heated humidification with low-flow oxygen delivery
In which setting did Franklin et al. find a lower rate of escalation of care with HFNC compared to low-flow oxygen for infants with bronchiolitis?
Pediatric ward and ICU
What is the recommended SpO2 range for infants and children with bronchiolitis according to the study?
SpO2 90–97%
What organization recommends oxygen delivery for SpO2 < 90% for children with signs of respiratory distress?
World Health Organization
Why is the liberal use of oxygen in pediatric emergencies cautioned against?
It can cause oxygen toxicity and absorption atelectasis
What is the main focus of the study conducted by the committee selected by the American Association for Respiratory Care (AARC) leadership?
Developing evidence-based guidelines for oxygen therapy in pediatric patients
What is the recommendation regarding the use of oxygen hoods or tents for hospitalized children according to the study?
Recommendation against the use of oxygen hoods or tents
What is the recommended oxygen delivery range for children with signs of respiratory distress according to the American Heart Association?
SpO2 94% and 99%
Study Notes
Guidelines for Oxygen Therapy in Hospitalized Children
- Oxygen is commonly used in pediatric patients to treat hypoxemia caused by various acute conditions.
- The liberal use of oxygen in pediatric emergencies is common due to its perceived benefits, but it can lead to overuse and hyperoxia, causing oxygen toxicity and absorption atelectasis.
- The delivery of oxygen in pediatric patients requires appropriate selection of the delivery device, concentration, and flow for effective therapy to avoid both hypoxia and hyperoxia.
- The World Health Organization recommends oxygen delivery for SpO2 < 90% for children with signs of respiratory distress, while the American Heart Association suggests administering and weaning oxygen to achieve SpO2 between 94% and 99%.
- The study aimed to develop evidence-based guidelines to assist clinicians in providing the best treatment of hypoxemia while limiting the adverse effects of oxygen therapy in pediatric patients.
- The study conducted a systematic review of peer-reviewed literature to develop clinical practice guidelines.
- The study focused on four key questions related to the utilization of oxygen therapy in hospitalized pediatric patients, including the use of oxygen tents and hoods, high-flow oxygen systems, humidification with supplemental oxygen, and disease-specific oxygenation targets.
- The committee for this endeavor was selected by the American Association for Respiratory Care (AARC) leadership based on their experience, interest, and commitment to the process.
- The committee developed four recommendations to assist clinicians in the utilization of oxygen therapy in hospitalized children, including the recommendation against the use of oxygen hoods or tents, the recommendation for the use of high-flow nasal cannula therapy, the recommendation against the application of humidification with low-flow oxygen delivery, and the recommendation for targeting SpO2 90–97% for infants and children with bronchiolitis.
- The study involved experts affiliated with institutions such as Children’s Hospital of Philadelphia, University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, and Liberty University.
- The study's authors disclosed their relationships and conflicts of interest with various companies and organizations.
- The study's corresponding author can be contacted at the Respiratory Therapy Department, Children’s Hospital of Philadelphia, for further information.
Test your knowledge of pediatric oxygen therapy guidelines with this quiz. Learn about the appropriate selection of delivery devices, concentration, and flow for effective therapy, as well as the recommendations for oxygen delivery in hospitalized children.
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