In low-and middle-income countries (LMICs), the scarcity of oxygen contributes to preventable child deaths, particularly those caused by hypoxemic pneumonia and sepsis. Inefficient use of medical oxygen can lead to unnecessary consumption, waste, and shortages, which may put critically ill patients at risk. To ensure equitable and rational allocation of this scarce resource, it is crucial to optimize its clinical use by matching supply to demand. Current WHO guidelines recommend using pulse oximetry to monitor SpO2 in children receiving oxygen therapy for respiratory distress at least twice a day. Pulse oximetry is a reliable and non-invasive measure of oxygen levels in the blood that can quickly detect hypoxemia and track its resolution. By adjusting oxygen flow rates based on continuous SpO2 measurements, health workers can ensure more efficient oxygen use and prevent waste of this precious resource. However, there is currently a lack of tools that can guide health workers in titrating oxygen in critically ill children, leading to unnecessary waste of oxygen and potential harm to patients from too little or too much oxygen.
To address this challenge, we aim to develop and evaluate a system that will allow us to adjust oxygen flow rates based on pulse oximetry feedback. Recruitment for this project began in 2024. Our current goal is to collect baseline data from a cohort of 200 critically ill children receiving oxygen treatment at a Holy Innocents Children's Hospital in Uganda.
We will use this clinical data to to develop and validate a model that describes the relationship between oxygen flow rate and SpO2. We will use this model to develop a clinical algorithm (Smart O2) and decision support system that guides health workers on oxygen titration based on continuous pulse oximetry monitoring.
- Dr. Stephen Businge - Pediatrician and Chief Executive Officer, Holy Innocents Children's Hospital, Uganda
- James Karugaba - Nursing Director, Holy Innocents Children's Hospital, Uganda
- Dr. Guy Dumont - Professor, University of British Columbia; Investigator, BC Children's Hospital Research Institute
- Dr. Mark Ansermino - Executive Medical Director, Global Health; Co-Director, Institute for Global Health; Professor, UBC Department of Anesthesia, Pharmacology and Therapeutics
Dr. Nathan Kenya-Mugisha – Executive Director, Walimu
Dr. Niranjan “Tex” Kissoon – Professor, UBC Departments of Pediatrics and Surgery (Emergency Medicine)
Dr. Roger Rassol - Professor, University of Melbourne, Australia
Charly Huxford - Research Assistant, Institute for Global Health
Dustin Dunsmuir - Global Health Technical Lead, Institute for Global Health
Ahmad Asdo - Research Assistant, Institute for Global Health
Aine Ivan Aye Ishebukara - Information Technology Speciality, Holy Innocents Children's Hospital and Walimu, Uganda
Nagaba Patience, Nurse, Holy Innocents Children's Hospital, Uganda
Twongyeirwe Mary, Nurse, Holy Innocents Children's Hospital, Uganda
Irankunda Joan, Nurse, Holy Innocents Children's Hospital, Uganda
Smart O2 is generously supported by the BC Children's Hospital Foundation.
Interested in learning more about the project? Contact Charly Huxford at charly.huxford@bcchr.ca
