Bronchiolitis Clinical Trial
Official title:
A Randomised Controlled Trial: Home Oxygen Therapy Versus Hospital Oxygen Therapy for Children With Acute Bronchiolitis
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.
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.
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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