AARC clinical practice guideline: Management of pediatric patients with oxygen in the acute care setting

Natalie Napolitano, Ariel Berlinski, Brian K. Walsh, Emily Ginier, Shawna L. Strickland

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Oxygen therapy is one of the most important therapeutics offered in the clinical management of pediatric patients with cardiopulmonary disease. As the medical community seeks to ensure evidence-based management of clinical interventions, we conducted a systematic review with the goal of providing evidence-based clinical practice guidelines to answer questions surrounding the use of simple oxygen therapy to improve oxygenation, including a comparison of delivery devices, the efficacy of humidification, comparison of flows, and goals for use in children. Using a modification of the RAND/UCLA Appropriateness Method, we developed 4 recommendations to assist clinicians in the utilization of oxygen therapy in hospitalized children: (1) the use of an oxygen hood or tent in lieu of a low-flow oxygen device for consistent oxygen delivery is not recommended; (2) the use of high-flow nasal cannula therapy is safe and more effective than low-flow oxygen to treat infants with moderate to severe bronchiolitis; (3) the application of humidification with low-flow oxygen delivery is not recommended; (4) targeting SpO2 90–97% for infants and children with bronchiolitis is recommended; however, no specific target can be recommended for pediatric patients with respiratory diseases outside of bronchiolitis, and establishing a patient/disease oxygen therapy target upon admission is considered best practice.

Original languageEnglish (US)
Pages (from-to)1214-1223
Number of pages10
JournalRespiratory care
Issue number7
StatePublished - Jul 1 2021
Externally publishedYes


  • Child
  • Infant
  • Oxygen
  • Pediatric

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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