Efficacy and acceptability of different modes of oxygen administration in children: implications for a community hospital. Oxygen administration to hypoxic children in Ethiopia: a randomized controlled study comparing complications in the use of nasal prongs with nasopharyngeal catheters. Comparison of nasal prongs with nasal catheters in the delivery of oxygen to children with hypoxia. Comparison of nasal prongs and nasopharyngeal catheter for the delivery of oxygen in children with hypoxemia because of a lower respiratory tract infection.
Eighty under-five children admitted in the pediatric ward with acute respiratory distress requiring oxygen inhalation were prospectively studied. Oxygen was administered to all the children by head box, face mask, nasopharyngeal catheter, and twin-holed prenasal catheter in a predetermined sequence. Oxygen was delivered at a flow rate of 4 l/min in the head box and by face mask and at a rate of 1 l/min for nasopharyngeal catheter and twin-holed prenasal catheter. There was a significant rise in paO2 and SaO2 values with all the oxygen delivery methods. The number of children who achieved paO2 of > 90 mmHg with oxygen delivered by head box was 53 (69 per cent), with face mask 37 (57 per cent), with nasopharyngeal catheter 13 (26 per cent), and with twin-holed prenasal catheter 18 (25 per cent). In view of high acceptability of twin-holed prenasal catheter, a further pilot study involving 10 children was carried out to compare the efficacy of head box and twin-holed prenasal catheter at an identical oxygen flow rate of 4 l/min. The number of children achieving paO2 of > 90 mmHg were comparable, i.e. seven (70 per cent) and eight (80 per cent) when the oxygen was delivered by head box and twin-holed prenasal catheter, respectively. It is concluded that both head box and twin-holed prenasal catheter are equally effective, acceptable and safe methods for administration of oxygen to children with acute respiratory disorders. In view of the cost-effectiveness, and easy availability and affordability of twin-holed prenasal catheter, it should be popularized in the small hospitals in the community, while head box should be reserved for use in the referral hospitals. Oxygen administration is one of the most important therapeutic interventions for a child with severe acute lower respiratory tract infection (ALRI). Inexpensive and efficient methods of oxygen administration are highly desirable in hospitals in developing countries. The objectives of this study were to compare the frequency and nature of complications when nasopharyngeal catheters or nasal prongs are used to deliver oxygen. One hundred and twenty-one children between the ages of 2 weeks and 5 years with hypoxia due to ALRI were randomized to receive oxygen via a catheter (61 children) or via nasal prongs (60 children). The two groups were similar in terms of diagnoses, clinical severity, oxygen saturation on admission and case fatality rates. There was no difference in the incidence of hypoxaemic episodes between the two groups. The oxygen flow rates required on the day of admission for adequate oxygenation (SaO2 > 90%) ranged from 0.8 litres per minute to 1.2 litres per minute. The required oxygen flow rate decreased during the course of treatment. Mucus production was more of a problem in the catheter group, and nasal blockage, intolerance of the method of oxygen administration and nursing effort were generally higher amongst the catheter group, but none of these differences was significant. Ulceration or bleeding of the nose was significantly more common in the catheter group (19.7% vs 6.7%, p < 0.05). Abdominal distension and nasal perforation were not seen in either group. This study suggests that nasal prongs are safer, more comfortable and require less nursing expertise than nasopharyngeal catheters for administration of oxygen to children. Efficient, inexpensive, and safe methods of oxygen delivery are needed for children with severe pneumonia in developing countries. The objective of this study was to estimate the frequency of complications when nasal catheters or nasal prongs are used to delivery oxygen. Ninety-nine children between 2 weeks and 5 years of age with hypoxia were randomized to receive oxygen via nasal catheter (49 children) or nasal prongs (50 children). There was no difference in the incidence of hypoxaemic episodes or in the oxygen flow rates between the two groups. Mucus production was more of a problem in the catheter group. Nasal blockage, intolerance to the method of administration, and nursing effort were generally higher amongst the catheter group, but these differences were not significant, except for nursing effort, when all age groups were analysed together. To determine the best method of oxygen delivery for children in developing countries who have hypoxemia caused by acute lower respiratory tract infection.
                One hundred eighteen children between 7 days and 5 years of age with a lower respiratory tract infection and arterial hemoglobin oxygen saturation (Sao2) less than 90% were randomly selected to receive oxygen by nasopharyngeal (NP) catheter (n = 56) or nasal prongs (n = 62). A crossover study to determine the flow rate necessary to achieve an Sao2 of 95% was performed in 60 children.
                One hundred twelve children could be oxygenated by the allocated method; in six oxygenation was poor with either method. The mean duration of therapy was 87.5 hours for the prongs and 94.9 hours for the NP catheter (not significant). The median oxygen consumption was 2142 L for prongs and 1692 L for the NP catheter (not significant). In the crossover study the prongs needed, on average, 26% higher oxygen flow rates than the NP catheter to obtain an Sao2 of 95% (p = 0.003). Complete nasal obstruction was observed in 24 of the children (44%) in the NP catheter group and in 8 (13%) in the prongs group (p < 0.001). Eighteen children died, 11 with NP catheter and 7 with prongs (not significant).
                Because nasal prongs are less prone to complications, and oxygenation in children is equally effective, they are a more appropriate method than the NP catheter for oxygen delivery to children in developing countries with acute lower respiratory tract infections.
NP and NPC seem to be similar in effectiveness and safety when used in patients with LRTI. There is no single clinical sign or symptom that accurately identifies hypoxaemia. Studies identifying the most effective and safe oxygen delivery method are needed.