The main objectives of this review were to determine the effectiveness and safety of non-invasive oxygen delivery systems in children's recovery from lower respiratory tract infections (LRTIs). Other objectives were to determine the indications for oxygen therapy, describe the clinical criteria for ending oxygen therapy, determine the indications for continuing oxygen therapy after discharge, and estimate costs associated with each method of oxygen delivery.
To answer these questions we conducted a wide search for randomised controlled trails (RCTs) of oxygen therapy in the treatment of LRTI in children. We did not find any trials comparing oxygen versus no oxygen. Only four RCTs and one systematic review met all the criteria for eligibility.
The evidence found suggests that nasal prongs may be more effective than nasopharyngeal and nasal catheters for delivering oxygen to paediatric patients with LRTI, particularly because nasal prongs have few secondary effects and no severe adverse events. However, the 95% confidence intervals (CI) obtained in the overall analysis of risk of treatment failure and risk of adverse events, showed a lack of precision in both cases. There is not enough evidence to determine which of the non-invasive delivery methods available should be used in the treatment of hypoxaemia in children with LRTI.
We found no clinical signs, model or score system that accurately identifies hypoxaemic children.
Since resources differ among settings, efficacy, patient tolerability, patient safety, cost and availability have to be considered when choosing the best non-invasive oxygen delivery method in the treatment of children with hypoxaemic LRTI. To aid health workers make the best decisions, studies aimed at identifying the most effective and safe non-invasive oxygen delivery method are required. Further research must consider the efficacy, tolerability, safety and costs of the methods studied .