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OP-026 Feasibility, safety, efficacy, utility of at-home O2-therapy for bronchiolitis
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  1. Agodomou Tossavi1,
  2. Gaudin Amandine1,
  3. Finci Sabine1,
  4. Peralta Aude1,
  5. Horvat Come1,
  6. Toumi Chadia1,
  7. Toin Tom2,
  8. Masson Elsa1,
  9. Penetta Luc1,
  10. Ouziel Antoine1,
  11. Receveur Matthieu1,
  12. Mezgueldi Ellia1,
  13. Delorme Sophie1,
  14. Suze Angélique1,
  15. Collot Sophie1,
  16. Cheyssac Philippe3,
  17. Chassery Carine3,
  18. Cantais Aymeric4,
  19. Launay Elise5,
  20. Guiheneuf Cécile6,
  21. Javouhey Etienne1,
  22. Haesebaert Julie7,
  23. Casalegno Jean-Sebastien8,
  24. Gillet Yves1,
  25. Ploin Dominique1
  1. 1Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d’Accueil des Urgences and Kids’ Lyon Infectious diseases Team (KIDs’LIT), Bron, France
  2. 2Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de pneumologie, allergologie, mucoviscidose, Bron, France
  3. 3Hospitalisation à domicile, Groupe Adène, Établissement d’HAD pédiatrique de Lyon, Lyon, France
  4. 4CHU de Saint Etienne, Service d’urgence Pédiatrique, Saint Etienne, France
  5. 5CHU de Nantes, Hôpital femme-enfant-adolescent, Hôpital enfant – adolescent pédiatrie, Nantes, France
  6. 6Association Française de Pédiatrie Ambulatoire, Orléans, France
  7. 7Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, Lyon, France
  8. 8Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon, France

Abstract

Aim Low respiratory tract infections is a leading cause of hospitalization, related to acute bronchiolitis (AB) and acute/subacute asthma (AA), and to mainly RSV/hRV-infections. Nutritional impairment and hypoxemia are the main indication for admission, and prolonged need for oxygen may lengthen the stay. We initiated a hospital-at-home (HAH) protocol for children in the steady-state prolonged low-flow oxygenotherapy phase (SS-LF-O2HAHP). Our retrospective study aimed to assess the feasibility, safety, acceptability, and utility of SS-LF-O2HAHP during 2022–2023 winter.

Material and Method Inclusion criteria: stable AB/AA after ≥24h monitoring, need of ≤1 lO2/min. Exclusion criteria: toxic aspect, fever, apnea, diarrhea, parental psychosocial difficulties, parental refusal, child’s home out of HAH intervention area. During the HAH, nurse contacts were daily. A HAH-nurse was available by phone 24/7 for parents, and a HAH-physician was available 24/7 by phone for the nurses. The outcomes were: The percentage of HAH-setups, the number of days of HAH-stay, the number of hospital readmission after HAH-discharge, the number of serious/non-serious adverse event (SAE/AE), and parental satisfaction.

Results Parental refusal led to 3 exclusions, 38 children were included (23 with AB and 15 with AA) and all had HAH-setup. SAE arose twice (5%): readmission in conventional departments: 1 with AB (new viral infection), 1 with AA (development of bronchiolitis obliterans). AE arose 5 times (21%): 4 O2-delivery failures (issue solved on the same day); 1 patient had an otitis media. Out of 12 satisfaction surveys, 100% of parents expressed complete satisfaction overall; 3 (8%) were not completely satisfied with the device (O2 delivery failure).

Conclusions The SS-LF-O2HAHP appeared feasible, safe, with high parental satisfaction. During the pilot phase, the capacity was limited to 1 child per open day; 332 saved days of hospital stay indicates high utility. Applying this model on a larger scale can create challenges in recruiting and managing the team of healthcare professionals.

  • Young children
  • Hospital at home
  • Low respiratory tract infection/hypoxemia
  • Healthcare organization
  • Pediatric emergency department

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