Efficiency of oxygen therapy by head box for acute respiratory failure in infants

Abstract

Oxygen therapy is the main treatment method for acute respiratory failure in children. The method consisting in the administration of oxygen therapy by head box to infants is frequently used in pediatric practice. Objectives. To evaluate the efficiency of oxygen therapy administered by head box to infants suffering from pneumonic acute respiratory failure by comparing two methods for measuring hemoglobin oxygen saturation: in arterialized capillary blood and by pulse oximetry. Material and method. 30 infants suffering from pneumonic acute respiratory failure were studied. We used a clinical appraisal score for acute respiratory failure, which appraises respiratory rate, nasal flaring, recession, cyanosis, sensorial, before and after oxygen therapy. In arterialized capillary blood we measured partial pressure of oxygen and hemoglobin oxygen saturation, and we used an Automatic Blood Gas System analyzer. We also measured hemoglobin oxygen saturation using a pulse oximeter. Determinations were made before the initiation of oxygen therapy, and 30 minutes and 60 minutes after the initiation of oxygen therapy. Results. As compared to the baseline values, determined before the initiation of oxygen therapy, we recorded a statistically significant improvement in the clinical score both after 30 minutes and 60 minutes from the initiation of oxygen therapy (p<0.001). The improvement was greater after 60 minutes. The increase in the partial pressure of oxygen was statistically significant both at the 30 minute and 60 minute determination (p<0.001). Both methods of SaO2 measurement recorded statistically significant increases (p<0.001) in this variable after 30 and 60 minutes, respectively. Conclusions. Oxygen therapy administered by head box improves acute respiratory failure appraised by clinical score. The administration of oxygen therapy by head box to infants significantly increases the values of partial pressure of oxygen and hemoglobin oxygen saturation measured in capillary blood, as well as the values of hemoglobin oxygen saturation determined by pulse oximeter both after 30 minutes and after 60 minutes. The increases in the three parameters are larger after 60 minutes. There is statistically significant concordance between the values of hemoglobin oxygen saturation determined in capillary blood and by pulse oximetry at all determinations.