Home oxygen therapy is a feasible option for infants with bronchiolitis, according to authors of a systematic review and meta-analysis. Studies conducted at both high altitude and sea level provide evidence of the safety and acceptability of this intervention, one that reduces hospital costs and should be studied for its overall cost-effectiveness.
From published randomized control trials, retrospective audits, and prospective observational trials of infants with bronchiolitis receiving Hospital-at-Home (HAH) care (oxygen, nasogastric feeding, remote monitoring), 10 reports met inclusion criteria. “HOT appears feasible in terms of uptake (70%–82%) and successful completion, both at altitude and sea-level,” the authors write. “Caregiver acceptability was reported in 2 qualitative studies. There were 7 reported adverse events (0.6%) with 0 mortality in 1257 patients. Cost studies showed evidence of savings, although included costs to hospitals only.”
“There is evidence to support the safety and feasibility of managing oxygen requirements for bronchiolitis in the home, especially in areas of high altitude,” conclude the authors. “Further studies at sea-level are required to better understand the role of HAH in bronchiolitis management. There is a need for more research to investigate the cost-effectiveness by including costs to society of oxygen therapy and exploring health care systems outside of the United States to investigate alternate strategies to reduce inpatient durations (such as lowering oxygen treatment thresholds further) and to examine the safety and feasibility of models of care to support other care requirements such as NGT feeding and observation of those at risk for deterioration.”