Department of Pediatrics, University of Alberta, Edmonton, Canada.
Université Catholique du Graben, Butembo, Democratic Republic of Congo; School of Public Health, University of Alberta, Edmonton, Canada.
Pulmonology. 2023 Jul-Aug;29(4):315-322. doi: 10.1016/j.pulmoe.2021.11.005. Epub 2021 Dec 20.
Pneumonia is a leading cause of childhood mortality globally. Children with severe pneumonia associated with hypoxaemia require oxygen (O) therapy, which is scarce across resource-constrained countries. Solar-powered oxygen (SPO2) is a novel technology developed for delivering therapeutic O in resource-constrained environments.
Is the introduction of SPO2 associated with a reduction in mortality, relative to the existing practice?
This was a pragmatic, quasi-experimental study comparing mortality amongst children < 5 years of age with hypoxaemic respiratory illness before and after the installation of SPO2 in two resource-constrained hospitals.
Participants were children < 5 years old admitted with acute hypoxaemic respiratory illness. The intervention was SPO2, installed at two resource-constrained hospitals. The primary outcome was 30-day mortality. Secondary outcomes included in-hospital mortality (time to death), length of hospital stay among survivors, duration of O therapy (time to wean O), and O delivery system failure(s).
Mortality amongst children admitted with acute hypoxaemic respiratory illness decreased from 30/50 (60%) pre-SPO2 to 15/50 (30%) post-SPO2 (relative risk reduction 50%, 95%CI 19 - 69, p = 0.0049). The post-SPO2 period was consistently associated with decreased mortality in statistical models adjusting for potential confounding factors. Likewise, survival curves pre- and post- SPO2 differed significantly (hazard ratio 0.39, 95% CI 0.20 - 0.74, p = 0.0043). A reduction in the frequency of O delivery interruptions due to fuel shortages and multiple patients needing the concentrator at once was observed, explaining the mortality reduction.
Solar-powered oxygen installation was associated with decreased mortality in resource-constrained settings.
肺炎是全球儿童死亡的主要原因。患有低氧血症相关严重肺炎的儿童需要接受氧气（O）治疗，但在资源有限的国家，这种治疗方式非常稀缺。太阳能供氧（SPO2）是一种为资源有限环境下提供治疗性 O 的新技术。
与现有治疗方法相比，引入 SPO2 是否与降低死亡率相关？
这是一项在资源有限的两家医院比较 SPO2 引入前后，患有低氧血症呼吸疾病的 5 岁以下儿童死亡率的实用、准实验研究。
参与者为患有急性低氧血症呼吸疾病的 5 岁以下儿童。干预措施是在两家资源有限的医院安装 SPO2。主要结局为 30 天死亡率。次要结局包括院内死亡率（死亡时间）、幸存者的住院时间、O 治疗时间（停止供氧时间）和 O 输送系统故障。
患有急性低氧血症呼吸疾病的儿童入院后死亡率从 SPO2 引入前的 30/50（60%）降至 SPO2 引入后的 15/50（30%）（相对风险降低 50%，95%CI 19-69，p=0.0049）。在调整潜在混杂因素的统计模型中，SPO2 引入后时期始终与死亡率降低相关。同样，SPO2 引入前后的生存曲线有显著差异（风险比 0.39，95%CI 0.20-0.74，p=0.0043）。由于燃料短缺和同时需要浓缩器的多个患者，O 输送中断的频率减少，这解释了死亡率的降低。
在资源有限的环境中，太阳能供氧的安装与死亡率的降低相关。
