National survey in pediatric patients on long-term home oxygen therapy

ABSTRACT
This study aims to describe current prescriptive practices regarding home long-term oxygen therapy (LTOT) in Italian pediatric population. The Chronic Respiratory Insufficiency and Long-Term Ventilation Study Group produced a survey that was sent to the referents of the Italian Society of Infantile Respiratory Diseases and of the Italian Society of Neonatology. Forty-two responses were collected from different centers: 32 (76%) participants declared to be LTOT prescribers. Of these, 8 (25%) reported following more than 30 patients, 3 (9%) between 20-30 patients, 9 (28%) between 10-20, 12 (37%) less than 10 patients. Twenty (63%) use blood gas test to decide starting LTOT, 7 (22%) use daytime and/or night-time oximetry, 5 (16%) use both. Twenty-two (69%) prescribe high-flow oxygen (HFNC), of which 8 (36%) to more than 5 patients/year and 14 (64%) to less. Patients receiving HFNC suffer from bronchopulmonary dysplasia (10/26, 38%), neurological disease (6/26, 23%), interstitial disease (6/26, 23%), oncological disease (2/26, 8%) or cystic fibrosis (2/26, 8%).
Results show that pediatric patients on LTOT are fewer than adult ones; most are infants with bronchopulmonary dysplasia or children with neurological disabilities, reflecting the increasing reality of medically complex children. Most prescribers use blood gas tests to initiate LTOT, despite the availability of less invasive methods such as oximetry. The data collected will prove to be useful to produce official recommendations to standardize LTOT indications, devices and therapeutic purposes.

IMPACT STATEMENT
There is a need for standardization of prescriptive practices for home long-term oxygen therapy (LTOT) in Italian pediatric population; the creation a national dataset could be useful for this aim.

Received: Oct 01, 2024
Accepted: Dec 17, 2024