Acute on Chronic Respiratory Event Score

Children with tracheostomy and home ventilation (HV) are at high risk of morbidity and mortality from acute respiratory infections (ARIs).1,2 American Thoracic Society guidelines have helped optimize the safety of children with HV at home.3 There remains, however, limited evidence to guide clinicians’ oversight for safe home management of ARIs and no systematic means of evaluating outpatient illness severity.4 Indeed, existing intensive care severity scores (eg, Pao2/Fio2, Spo2/Fio2 ratio calculations, ROX index, Oxygenation Index, Oxygen Saturation Index) are not applicable due to the (1) lack of laboratory assessments in the home (eg, blood gases) and (2) differences in oxygen delivery mechanisms between home (eg, liter flow) and hospital (eg, Fio2).