Safety Study of Home Oxygen Therapy for Children With Acute Bronchiolitis
Condition: Bronchiolitis
MeSH terms: Bronchiolitis
Study type: Interventional
Phase: Phase 3

Summary: 
      Home oxygen therapy is considered an appropriate and relatively safe option for children with
      chronic respiratory problems such as chronic lung disease of prematurity, but the use of home
      oxygen therapy for children with acute respiratory problems is limited. With the recent
      establishment of a "Hospital in The Home" (HiTH) program at our institution, we sought to
      determine the safety, parental satisfaction and economic advantage of home oxygen therapy for
      children with acute bronchiolitis compared with traditional inpatient hospitalization.
    

Detailed description: 
      Acute bronchiolitis is the most common reason for hospital admission in children aged less
      than 1 year in developed countries. Over the last 25 years, hospitalization rates and
      admission duration have increased dramatically, resulting in substantial health care costs
      for both institutions and individual families.

      There are currently no pharmacological therapies for acute bronchiolitis that have been shown
      to consistently alter the natural history of this disease. Current evidence suggests that
      management is essentially supportive, consisting of oxygen supplementation if the child is
      hypoxic and nasogastric feeds or intravenous fluids if the child is dehydrated. Oxygen
      supplementation is the principal determinant of the length of hospital admission for children
      with acute bronchiolitis and the need for supplemental oxygen is generally considered to be
      an absolute indication for hospitalization. However, Bajaj et al demonstrated that a
      carefully selected population of children with acute bronchiolitis can be managed safely with
      home oxygen therapy.

      The escalating demand and cost of health care has driven health reforms in many countries,
      including Australia and the United Kingdom. These reforms have included the development of
      services that allow patients with a range of illnesses to be managed safely in their own home
      rather than hospital. Such services have been well established for children with a number of
      chronic conditions and although managing children with acute illnesses at home is not a new
      strategy, this model of care is increasingly considered an alternative to traditional
      in-patient hospitalisation. In addition to the financial benefits of transferring care to the
      patients' homes for health care providers and families, children and parents report a strong
      preference for such models of care.

      Home oxygen therapy is considered an appropriate and relatively safe option for children with
      chronic respiratory problems such as chronic lung disease of prematurity, but the use of home
      oxygen therapy for children with acute respiratory problems is limited. With the recent
      establishment of a "Hospital in The Home" (HiTH) program at our institution, we sought to
      determine the safety, parental satisfaction and economic advantage of home oxygen therapy for
      children with acute bronchiolitis compared with traditional inpatient hospitalization.
    

Intervention name(s): Home oxygen therapy
Intervention type(s): Procedure
Intervention description(s): Administer oxygen at home or in hospital
Other intervention name(s): Home oxygen; Hospital oxygen
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: bronchiolitis; oxygen; children