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Vol. 89. Issue 1.
Pages 6-17 (January - February 2013)
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Vol. 89. Issue 1.
Pages 6-17 (January - February 2013)
Review article
Open Access
Recommendations for Long-term Home Oxygen Therapy in Children and Adolescents
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Fabíola V. Addea,
Corresponding author
fabiola.adde@yahoo.com.br

Corresponding author.
, Alfonso E. Alvarezb, Beatriz N. Barbisanc, Bianca R. Guimarãesd
a PhD in Medicine, Universidade de São Paulo Medical School (FMUSP), São Paulo, SP, Brazil. Primary Physician, Pneumology Unit, Instituto da Criança, Hospital das Clínicas, FMUSP, São Paulo, SP, Brazil. Department of Pneumology, Sociedade de Pediatria de São Paulo, São Paulo, SP, Brazil
b MSc. PhD Candidate in Child and Adolescent Health, Medical Sciences School, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil. President, Department of Pediatrics, Sociedade de Medicina e Cirurgia de Campinas (2012-2014), Campinas, SP, Brazil. Department of Pneumology, Sociedade de Pediatria de São Paulo, São Paulo, SP, Brazil
c MSc in Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. Primary Physician, Pediatric Pneumology Section, Department of Pediatrics, UNIFESP, São Paulo, SP, Brazil. Department of Pneumology, Sociedade de Pediatria de São Paulo, São Paulo, SP, Brazil
d MSc in Pediatrics, FMUSP, São Paulo, SP, Brazil. Pediatric Pulmonologist. Member, Department of Pneumology, Sociedade de Pediatria de São Paulo, São Paulo, SP, Brazil
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Article information
Abstract
Objective

To advise pediatricians, neonatologists, pulmonologists, pediatric pulmonologists, and other professionals in the area on the main indications and characteristics of long-term home oxygen therapy in children and adolescents.

Data source

A literature search was carried out in the MEDLINE/PubMed database (1990 to 2011). Additionally, references from selected studies were included. As consistent scientific evidence does not exist for many aspects, some of the recommendations were based on clinical experience.

Data synthesis

Long-term home oxygen therapy has been a growing practice in pediatric patients and is indicated in bronchopulmonary dysplasia, cystic fibrosis, bronchiolitis obliterans, interstitial lung diseases, and pulmonary hypertension, among others. The benefits are: decrease in hospitalizations, optimization of physical growth and neurological development, improvement of exercise tolerance and quality of sleep, and prevention of pulmonary hypertension/cor pulmonale. The levels of oxygen saturation indicative for oxygen therapy differ from those established for adults with chronic obstructive pulmonary disease, and vary according to age and disease. Pulse oximetry is used to evaluate oxygen saturation; arterial blood gas is unnecessary. There are three available sources of oxygen: gas cylinders, liquid oxygen, and oxygen concentrators. The flows used are usually smaller, as are the number of hours/day needed when compared to the use in adults. Some diseases show improvement and oxygen therapy discontinuation is possible.

Conclusions

Long-term home oxygen therapy is increasingly common in pediatrics and has many indications. There are relevant particularities when compared to its use in adults, regarding indications, directions for use, and monitoring.

Keywords:
Home oxygen therapy
Children
Oxygen
Resumo
Objetivo

Orientar pediatras, neonatologistas, pneumologistas, pneumologistas pediátricos e outros profissionais envolvidos na área sobre as principais indicações e as particularidades da oxigenoterapia domiciliar prolongada em crianças e adolescentes.

Fontes dos dados

Pesquisa bibliográfica na base de dados MEDLINE/PubMed (1990 a 2011). Adicionalmente, referências de estudos selecionados foram incluídas. Como para muitos dos aspectos não existem evidências científicas consistentes, algumas recomendações citadas foram feitas com base em experiência clínica.

Síntese dos dados

Oxigenoterapia domiciliar prolongada tem sido uma prática crescente nos pacientes pediátricos e se encontra indicada em casos de displasia broncopulmonar, fibrose cística, bronquiolite obliterante, pneumopatias intersticiais, hipertensão pulmonar, etc. Ressaltam-se como benefícios: redução de internações, otimização do crescimento físico e do desenvolvimento neurológico, melhora da tolerância ao exercício e da qualidade do sono e prevenção da hipertensão pulmonar/Cor pulmonale. Os níveis de saturação de oxigênio indicativos para a oxigenoterapia diferem dos estabelecidos para adultos com doença pulmonar obstrutiva crônica e variam de acordo com a doença e faixa etária. Para a avaliação da saturação de oxigênio, utiliza-se a oximetria de pulso, sendo a gasometria arterial dispensável. Há três fontes de oxigênio disponíveis: cilindros gasosos, oxigênio líquido e concentradores de oxigênio. Os fluxos utilizados costumam ser menores, assim como o número de horas/dia necessários, quando comparados ao uso em adultos. Em algumas doenças há melhora, e a suspensão do oxigênio é possível.

Conclusões

Oxigenoterapia domiciliar prolongada é uma terapêutica cada vez mais comum em pediatria e suas indicações são numerosas. Há particularidades relevantes quando comparada aos adultos em relação às indicações, modo de uso e monitorização.

Palavras-chave:
Oxigenoterapia domiciliar
Crianças
Oxigênio
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Please, cite this article as: Adde FV, Alvarez AE, Barbisan BN, Guimarães BR. Recommendations for long-term home oxygen therapy in children and adolescents. J Pediatr (Rio J). 2013;89:6−17.

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