Abstract
Objective
Retrospective studies performed have shown home oxygen to be a safe alternative to hospitalization for some patients with bronchiolitis living at high altitudes. We aimed to prospectively describe adverse events, follow-up, duration of home oxygen, factors associated with failure, and caregiver preferences.
Methods
This was a prospective observational study of hypoxemic bronchiolitis patients ages 3-18months who were discharged from a tertiary care pediatric emergency department on home oxygen over 3 winters (2011-2014). Caregivers were contacted on post-discharge days ~3, 7, 14 and 28 while on oxygen. Caregivers not reached by phone were sent a survey and PCPs were contacted. Records of admitted subjects were reviewed. Outcome measures included: Hospital readmission, positive pressure ventilation (noninvasive or intubation), outpatient follow-up, duration of home oxygen therapy, and caregiver satisfaction.
Results
274 patients were enrolled. 48 (17.5%) were admitted and 225(82.1%) were discharged on oxygen. The median age was 8 months. 18 subjects were lost to follow-up. 196 (87.1%) were successfully treated with outpatient oxygen, and 11 (4.9%) failed outpatient therapy and were hospitalized. Only 1 hospitalized patient required invasive ventilation. The median duration of home oxygen was 7 days. Child noncompliance was the most common problem (reported by14%). The median caregiver comfort level with home oxygen was 9/10. 88% of caregivers would again choose home oxygen over admission.
Conclusions
This study confirms that outpatient oxygen therapy can reduce hospitalizations due to bronchiolitis in a relatively high-altitude setting, with low failure and complication rates. Caregivers are comfortable with home oxygen and prefer it to hospitalization.
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