Hanging on to Oxygen..the usual suspects

Children with acute respiratory illnesses usually need a short period of oxygen supplementation. In some children this oxygen requirement gets prolonged even when other markers of disease like fever and feeding have improved. Identifying the clinical characteristics of these patients will allow better understanding of the reasons why some children need oxygen for longer and may allow us to plan for alternative methods of care like Hospital at home. <bold>Objectives:</bold> To dilineate the clinical characterstics of patients who develop a prolonged oxygen requirement following a lower respiratory tract infection (LRTI). <bold>Methods:</bold> This was a retrospective study examining the hospital records of patients presnting with LRTIs who needed prolonged oxygen therapy, defined as oxygen therapy >7 days. Children on home oxygen or known chronic respiratory disorders were excluded. <bold>Results:</bold> Out of 903 admissions for LRTIs in the year, 27(21 infants) patients had a 31 admissions needing oxygen >7 days. Of these children there was a history of prematurity in 29.6%,cardiac co-morbidities in 22% and neurological abnormalities in 11.1%.RSV was the commonest organism (62.5%) followed by Rhinovirus(37.5%) and around half (45%)had multiple viruses isolated.38% of these children had needed escalation to intensive care for respiratory support. Half had been treated with High Flow oxygen therapy.3% children were discharged on home oxygen.70% had focal X-ray changes. <bold>Conclusions:</bold> Our results show that the known risk factors for hospital admission with bronchiolitis/LRTI are also the same risk factors for a prolonged oxygen requirement. Children with focal Xray changes and those who were sicker and had needed intensive care were more likely to need oxygen beyond 7 days.