Several parents returned to the clinic this week with their children on oxygen after respiratory illness. Our protocol has been to discontinue the oxygen when their saturation is above 89 in clinic. Now that many parents have a home pulse oximeter, children are using oxygen for longer periods. Measurements at home may be fine during the day, and the child attends school, then decreases at night so parents continue oxygen. since most oxygen equipment is rented by the month, this is not more expensive. I think it helps the lungs to heal, possibly reducing future problems such as pulmonary hypertension.
New information comes from one of the students rotating here at Ebert Family Clinic: Justin Lockwood, a pediatric resident. He reports that even in Denver some children require oxygen during respiratory illnesses that do not get a diagnoses of asthma or pneumonia.
Overflow crowd tonight at St. John’s church where Katherine Jeter shared her story of climbing Mt Kilimanjaro with others from the county, celebrating her 75th birthday that year. I am so inspired by the people older than I am who are challenging themselves like this. This peak is a mile higher than our 14er’s! The average age in this group was 65. Using acetazolamide/Diamox helped many of the climbers.
This article was published in the Archives of Disease in Childhood in 2009.
The authors reviewed 14 studies in the scientific literature for normal oxygen values for children ages 1 week to 12 years.
Hypoxemia (low oxygen) was defined as oxygen saturation at or below the 2.5th% for healthy children at a given altitude.
At 8,200 feet (2,500 meters) elevation 97.5 % of children had oxygen concentrations above 90%
At 10,498 feet (3,200 meters) elevation this decreased to 85%, with 2.5 % of children were below this.
Should children living in Leadville, Alma and Fairplay be allowed to go untreated when their oxygen levels are 85-89%?
Now that many families have a pulse oximeter parents are measuring their children’s oxygen levels when they are sick, and presumably when they are well.
Therefore deciding when a child has a low oxygen that needs treatment can be based on the child’s levels when healthy. Unfortunately, these oximeters are not accurate in infants.