↓ Skip to main content

Wellcome Open Research

Children’s Oxygen Administration Strategies Trial (COAST):  A randomised controlled trial of high flow versus oxygen versus control in African children with severe pneumonia

Overview of attention for article published in Wellcome Open Research, October 2017
Altmetric Badge

Mentioned by

twitter
54 X users
facebook
1 Facebook page
googleplus
1 Google+ user

Citations

dimensions_citation
22 Dimensions

Readers on

mendeley
58 Mendeley
Title
Children’s Oxygen Administration Strategies Trial (COAST):  A randomised controlled trial of high flow versus oxygen versus control in African children with severe pneumonia
Published in
Wellcome Open Research, October 2017
DOI 10.12688/wellcomeopenres.12747.1
Pubmed ID
Authors

Kathryn Maitland, Sarah Kiguli, Robert O. Opoka, Peter Olupot-Olupot, Charles Engoru, Patricia Njuguna, Victor Bandika, Ayub Mpoya, Andrew Bush, Thomas N. Williams, Richard Grieve, Zia Sadique, David Harrison, Kathy Rowan

Abstract

Background: In Africa, the clinical syndrome of pneumonia remains the leading cause of morbidity and mortality in children in the post-neonatal period. This represents a significant burden on in-patient services. The targeted use of oxygen and simple, non-invasive methods of respiratory support may be a highly cost-effective means of improving outcome, but the optimal oxygen saturation threshold that results in benefit and the best strategy for delivery are yet to be tested in adequately powered randomised controlled trials. There is, however, an accumulating literature about the harms of oxygen therapy across a range of acute and emergency situations that have stimulated a number of trials investigating permissive hypoxia. Methods: In 4200 African children, aged 2 months to 12 years, presenting to 5 hospitals in East Africa with respiratory distress and hypoxia (oxygen saturation < 92%), the COAST trial will simultaneously evaluate two related interventions (targeted use of oxygen with respect to the optimal oxygen saturation threshold for treatment and mode of delivery) to reduce shorter-term mortality at 48-hours (primary endpoint), and longer-term morbidity and mortality to 28 days in a fractional factorial design, that compares: Liberal oxygenation (recommended care) compared with a strategy that permits hypoxia to SpO 2 > or = 80% (permissive hypoxia); andHigh flow using AIrVO 2TM compared with low flow delivery (routine care). Discussion: The overarching objective is to address the key research gaps in the therapeutic use of oxygen in resource-limited setting in order to provide a better evidence base for future management guidelines. The trial has been designed to address the poor outcomes of children in sub-Saharan Africa, which are associated with high rates of in-hospital mortality, 9-10% (for those with oxygen saturations of 80-92%) and 26-30% case fatality for those with oxygen saturations <80%. Clinical trial registration: ISRCTN15622505 Trial status: Recruiting.

X Demographics

X Demographics

The data shown below were collected from the profiles of 54 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 58 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 58 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 9 16%
Researcher 8 14%
Student > Ph. D. Student 8 14%
Student > Master 6 10%
Other 6 10%
Other 10 17%
Unknown 11 19%
Readers by discipline Count As %
Medicine and Dentistry 27 47%
Nursing and Health Professions 6 10%
Agricultural and Biological Sciences 2 3%
Engineering 2 3%
Social Sciences 2 3%
Other 5 9%
Unknown 14 24%