Overreliance on Pulse Oximetry in Managing Infant Bronchiolitis? — Physician’s First Watch
Overreliance on Pulse Oximetry in Managing Infant Bronchiolitis?
By Kelly Young
Edited by Lorenzo Di Francesco, MD, FACP, FHM
Pulse oximetry should not be the sole factor in deciding whether to admit an infant presenting with bronchiolitis, the authors of a JAMA study suggest. They say the decision should be based mainly on the infant's degree of respiratory distress and hydration status.
Over 200 infants presenting to the emergency department with mild-to-moderate bronchiolitis (oxygen saturation, 88% or higher) were randomized to receive true pulse oximetry readings or to have their oxygen values manipulated so that the monitor showed levels 3 percentage points above the actual measurement. In the true oximetry group, 41% were admitted to the hospital within 72 hours, versus 25% in the manipulated oximetry group.
Editorialists conclude: "It is now clear that the oxygen saturation reading can influence decision making in ways that many clinicians have thought likely — overreliance on physiologic information of uncertain importance derived from a medical device."