The children's oxygen administration strategies trial

Kathryn Maitland; Sarah Kiguli; Peter Olupot Oluput; Mainga Hamaluba; Karen Thomas; Florence Alaroker; Robert Opoka; Abner Tagoola; Victor Bandika; Ayub Mpoya

The children's oxygen administration strategies trial

Kathryn Maitland, Sarah Kiguli, Peter Olupot Oluput, Mainga Hamaluba, Karen Thomas, Florence Alaroker, Robert Opoka, Abner Tagoola, Victor Bandika, Ayub Mpoya

Medical College, East Africa

Research output: Contribution to journal › Article

Abstract

Background: The life-saving role of oxygen therapy in children with clinically-defined severe pneumonia is not yet established. We hypothesised liberal oxygenation strategies and/or respiratory support may improve the high in-hospital mortality.

Methods: The open-label fractional-factorial COAST trial in Ugandan and Kenyan children aged >28 days with feature of severe pneumonia. In stratum A (severe hypoxaemia: SpO2 3hours receipt of oxygen were excluded. The primary endpoint was 48-hour mortality; secondary endpoints included mortality or neurocognitive sequelae at 28 days.

Findings: The Trial Steering Committee recommended halting recruitment for feasibility after 1842/4200 (44%) children enrolled. Of 1852 recruited, 388 in stratum A (median 7 months; median age SpO2 75%) were randomised to HFNT (n=194) or LFO (n=194) and 1454 in stratum B (median 9 months; median SpO2 88%) were randomised to HFNT (n=363) vs LFO (n=364) vs control (n=727). Per-protocol 109/726(15%) of controls received oxygen (when SpO2

Interpretation: Conservative oxygen strategies appear safe and respiratory support with HFNT showing potential benefit should prompt further trials.

Original language	Undefined/Unknown
Journal	Paediatrics and Child Health, East Africa
Publication status	Published - 1 Apr 2020

Access to Document

http://ecommons.aku.edu/eastafrica_fhs_mc_paediatr_child_health/324

Cite this

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title = "The children's oxygen administration strategies trial",

abstract = "Background: The life-saving role of oxygen therapy in children with clinically-defined severe pneumonia is not yet established. We hypothesised liberal oxygenation strategies and/or respiratory support may improve the high in-hospital mortality. Methods: The open-label fractional-factorial COAST trial in Ugandan and Kenyan children aged >28 days with feature of severe pneumonia. In stratum A (severe hypoxaemia: SpO2 3hours receipt of oxygen were excluded. The primary endpoint was 48-hour mortality; secondary endpoints included mortality or neurocognitive sequelae at 28 days. Findings: The Trial Steering Committee recommended halting recruitment for feasibility after 1842/4200 (44\%) children enrolled. Of 1852 recruited, 388 in stratum A (median 7 months; median age SpO2 75\%) were randomised to HFNT (n=194) or LFO (n=194) and 1454 in stratum B (median 9 months; median SpO2 88\%) were randomised to HFNT (n=363) vs LFO (n=364) vs control (n=727). Per-protocol 109/726(15\%) of controls received oxygen (when SpO2 Interpretation: Conservative oxygen strategies appear safe and respiratory support with HFNT showing potential benefit should prompt further trials.",

author = "Kathryn Maitland and Sarah Kiguli and Oluput, \{Peter Olupot\} and Mainga Hamaluba and Karen Thomas and Florence Alaroker and Robert Opoka and Abner Tagoola and Victor Bandika and Ayub Mpoya",

year = "2020",

month = apr,

day = "1",

language = "Undefined/Unknown",

journal = "Paediatrics and Child Health, East Africa",

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TY - JOUR

T1 - The children's oxygen administration strategies trial

AU - Maitland, Kathryn

AU - Kiguli, Sarah

AU - Oluput, Peter Olupot

AU - Hamaluba, Mainga

AU - Thomas, Karen

AU - Alaroker, Florence

AU - Opoka, Robert

AU - Tagoola, Abner

AU - Bandika, Victor

AU - Mpoya, Ayub

PY - 2020/4/1

Y1 - 2020/4/1

N2 - Background: The life-saving role of oxygen therapy in children with clinically-defined severe pneumonia is not yet established. We hypothesised liberal oxygenation strategies and/or respiratory support may improve the high in-hospital mortality. Methods: The open-label fractional-factorial COAST trial in Ugandan and Kenyan children aged >28 days with feature of severe pneumonia. In stratum A (severe hypoxaemia: SpO2 3hours receipt of oxygen were excluded. The primary endpoint was 48-hour mortality; secondary endpoints included mortality or neurocognitive sequelae at 28 days. Findings: The Trial Steering Committee recommended halting recruitment for feasibility after 1842/4200 (44%) children enrolled. Of 1852 recruited, 388 in stratum A (median 7 months; median age SpO2 75%) were randomised to HFNT (n=194) or LFO (n=194) and 1454 in stratum B (median 9 months; median SpO2 88%) were randomised to HFNT (n=363) vs LFO (n=364) vs control (n=727). Per-protocol 109/726(15%) of controls received oxygen (when SpO2 Interpretation: Conservative oxygen strategies appear safe and respiratory support with HFNT showing potential benefit should prompt further trials.

AB - Background: The life-saving role of oxygen therapy in children with clinically-defined severe pneumonia is not yet established. We hypothesised liberal oxygenation strategies and/or respiratory support may improve the high in-hospital mortality. Methods: The open-label fractional-factorial COAST trial in Ugandan and Kenyan children aged >28 days with feature of severe pneumonia. In stratum A (severe hypoxaemia: SpO2 3hours receipt of oxygen were excluded. The primary endpoint was 48-hour mortality; secondary endpoints included mortality or neurocognitive sequelae at 28 days. Findings: The Trial Steering Committee recommended halting recruitment for feasibility after 1842/4200 (44%) children enrolled. Of 1852 recruited, 388 in stratum A (median 7 months; median age SpO2 75%) were randomised to HFNT (n=194) or LFO (n=194) and 1454 in stratum B (median 9 months; median SpO2 88%) were randomised to HFNT (n=363) vs LFO (n=364) vs control (n=727). Per-protocol 109/726(15%) of controls received oxygen (when SpO2 Interpretation: Conservative oxygen strategies appear safe and respiratory support with HFNT showing potential benefit should prompt further trials.

M3 - Article

JO - Paediatrics and Child Health, East Africa

JF - Paediatrics and Child Health, East Africa

ER -