Evidence map›Paper›PMID 40597123›Full record

Trial reportBMC medicine2025

Early weaning from oxygen therapy in African children with severe pneumonia.

Kathryn Maitland, Elisa Giallongo, Mainga Hamaluba, Florence Alaroker, Robert O Opoka, Abner Tagoola, Damalie Nalwanga, Eva Nabawanuka, William Okiror, Margaret Nakuya and 11 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Kathryn MaitlandDepartment Surgery and Cancer, Institute of Global Health Innovation, Imperial College London, London, UK. k.maitland@imperial.ac.uk.ORCID http://orcid.org/0000-0002-0007-0645
Elisa GiallongoClinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK.
Mainga HamalubaKenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme, Kilifi, Kenya.
Florence AlarokerSoroti Regional Referral Hospital, Soroti, Uganda.
Robert O OpokaDepartment of Paediatrics, School of Medicine, Makerere University and Mulago Hospital, Kampala, Uganda.
Abner TagoolaJinja Regional Referral Hospital, Jinja, Uganda.
Damalie NalwangaDepartment of Paediatrics, School of Medicine, Makerere University and Mulago Hospital, Kampala, Uganda.
Eva NabawanukaDepartment of Paediatrics, School of Medicine, Makerere University and Mulago Hospital, Kampala, Uganda.
William OkirorFaculty of Health Sciences, Busitema University, Mbale Campus, Mbale, Uganda.
Margaret NakuyaSoroti Regional Referral Hospital, Soroti, Uganda.
Denis AromutSoroti Regional Referral Hospital, Soroti, Uganda.
Thomas N WilliamsDepartment Surgery and Cancer, Institute of Global Health Innovation, Imperial College London, London, UK.
Karen ThomasClinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK.
David A HarrisonClinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK.
Paul MounceyClinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK.
Andrew BushImperial Centre for Paediatrics and Child Health, St Marys Hospital, London, UK.
J F FraserCritical Care Research Group and Intensive Care Service, University of Queenslandand, The Prince Charles Hospital , Brisbane, Australia.
Kathy RowanClinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK.
Peter Olupot-Olupot *Faculty of Health Sciences, Busitema University, Mbale Campus, Mbale, Uganda.
Sarah Kiguli *Department of Paediatrics, School of Medicine, Makerere University and Mulago Hospital, Kampala, Uganda.
COAST trial group

Funding

European and Developing Countries Clinical Trials Partnership RIA2016S-1636Joint Global Health Trials (MRC, Foreign Commonwealth and Department Office and Wellcome) MR/L004364/1Wellcome Trust
6 · The paper itself

Abstract

backgroundIn Africa, severe pneumonia remains the major cause of paediatric hospitalisation, resulting in high requirements for oxygen therapy. Adequate supplies of oxygen are key challenges for many low-resource hospitals. The World Health Organization manual for oxygen therapy advises 2-3 days of oxygen therapy for pneumonia and recommends against early weaning, even in the absence of hypoxaemia. Few data support this recommendation. We describe the oxygen use and timing of weaning in the COAST trial of oxygen therapy (ISRCTN15622505).

methodsChildren aged 28 days to 12 years presenting to 6 hospitals in Uganda and Kenya with severe pneumonia and hypoxaemia (saturations < 92% on pulse oximetry (SpO

resultsOf the 1842 children enroled the majority, 1454 (79%) had moderate hypoxaemia. In this stratum, by 2 and 8 h, 148 (41%) and 200/360 (55.6%) in the LFO arm had been weaned; in the HFNT arm, 213/362 (59%) were receiving respiratory support at 2 h in room alone, and by 8 h, 164/362 (45%) had been weaned. At 48 h, in the respective strata, 77-80% and 53-63% still had respiratory distress but without hypoxaemia and were thus not receiving oxygen. Median oxygen use at 48 h in the moderate hypoxaemia group was highest in LFO am 480L (IQR 236.2, 2132.2) compared to 113.4 L (IQR 0.0, 1453.9) in the HFNT and 0 L (IQR 0.0) in the control arms. Children requiring oxygen beyond 48 h, 17/33 (51.1%) and 9/46 (19.5%) in the respective strata, had additional cardiac conditions.

conclusionsClosely monitoring SpO

Indexed as

HypoxiaOxygen Inhalation TherapyPneumoniaChildChild, PreschoolFemaleHumansInfantInfant, NewbornKenyaMaleOximetryOxygenUgandaOxygenAfrican childrenHigh flow nasal therapyOxygen therapySevere pneumonia

Identifiers

PMID40597123
PMCPMC12220327

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.