Oxygen therapy for children with acute respiratory infections in small hospitals.

Oxygen administration is one of the most important modalities of therapy for a patient with hypoxaemia to prevent death and disability from common conditions such as acute lower respiratory tract infections. Oxygen needs to be available at all times in hospitals, however, it is too expensive for many developing countries. There is little information for health professionals regarding indications for initiating oxygen therapy, selecting appropriate method of oxygen administration and deciding on the source for oxygen. A review of the literature using medline citations and cross references from published articles and other manuscripts was made. The review described the two main sources of oxygen for small hospital-cylinders and oxygen concentrators and their advantages and disadvantages. It also looked at the evidences for clinical indications to initiate and discontinue oxygen therapy. Studies on efficient and safe methods of administration of oxygen were reviewed as well. The review concluded that oxygen may be administered in children with cyanosis, chest indrawing, inability to drink or breastfeed, tachypnea with respiratory rate above 70/minute or in a child who develops restlessness and improves on oxygen. The initial capital cost of concentrators is high but the running cost is low and it does not require transport while oxygen cylinders are expensive to transport and need continuous refilling. The safest method of oxygen administration are the prongs followed by the nasal catheters.