Experts call for effective oxygen therapy to cure children with respiratory issues

Wise use of oxygen therapy at health facilities can save lives of hundreds of children suffering from pneumonia, acute respiratory distress syndrome (ARDS) and other diseases, leading public health experts and paediatricians on Monday said, adding that the first draft of the National Oxygen Therapy Guidelines had been prepared for consultation and dissemination in the country.

“Lack of national oxygen therapy guidelines results in loss of hundreds of lives of children annually in Pakistan as a majority of healthcare professionals were not aware as to how and when to use oxygen to save lives of children. In consultation with the Pakistan Paediatric Association [PPA], Unicef and WHO, we have come up with the first draft of the National Oxygen Therapy Guidelines for Children in Pakistan,” Health Services Academy (HSA) Islamabad Vice Chancellor Dr Shahzad Ali Khan told The News on Monday.

Monitoring of oxygen saturation with the help of pulse oximetry and use of oxygen therapy in people with acute respiratory distress syndrome (ARDS) with the help of Bipap, Cpap machines and ventilators during the Covid-19 pandemic saved thousands of lives in the country, he said, adding that we could learn from the oxygen therapy during the pandemic how it could be used effectively to save thousands of lives of children in the days to come.

He maintained that as per the WHO, the current birth rate for Pakistan in 2022 was 26.538 births per 1,000 people. Newborns with heart, lung or respiratory problems may need to breathe increased amounts of oxygen to get normal levels of oxygen in their blood.

“Oxygen therapy provides the newborn babies with extra oxygen. Medical oxygen is a lifesaving, essential gas that is important for the treatment of many common childhood conditions. But at the same time, breathing too much oxygen can damage the lungs,” Dr Khan said warning that for premature babies, too much oxygen in the blood may lead to problems in the brain and eyes.

Patients with certain heart conditions may also need lower levels of oxygen in the blood, he said, adding that in order to address these concerns and instructional gaps in Pakistan, the HAS in collaboration with the PPA, Unicef and WHO held a national dialogue and came up with the draft National Oxygen Therapy Guidelines for children.

PPA Secretary General Dr Khalid Shafi said they were striving for preparation of the guidelines since long and finally they had finalised a draft which was being reviewed. He explained that after the guidelines were finalised, they would be disseminated among the healthcare facilities throughout the country and trainings would also be held on the effective use of oxygen therapy.

“Covid-19 has taught us very important lessons and one of them is the use of oxygen wisely to save lives, especially of children. Unfortunately, most of the healthcare professionals as well paramedical staff is not aware when and how they should use oxygen, especially for children,” Dr Shafi said, adding that once the guidelines were finalised, it would be an important milestone in saving lives of children in Pakistan.

Sindh Institute of Child Health (SICH) Executive Director Prof Jamal Raza remarked that if a trained healthcare professional knew that a sick child was in need of the oxygen therapy, the lives of scores of children could be saved. He added that every day, hundreds of children were brought to health facilities with respiratory distress who needed oxygen therapy.

However, he said, oxygen was a costly intervention and in tertiary-care health settings, it was misused as nobody knew how much oxygen should be given to children. He added that the oxygen therapy guidelines could be helpful in the treatment of children in remote areas of the country.

Officials at the HSA said some leading health experts, including Prof Dr Maj Gen Salman Ali, Dr Tabinda Zaman, Dr Nabila Zaka and others, have provided help in the formulation of the draft guidelines.