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Reliance on Oximetry Readings Increases Hospital Admissions for Mild-to-Moderate Bronchiolitis

August 26, 2014

Reliance on Oximetry Readings Increases Hospital Admissions for Mild-to-Moderate Bronchiolitis

  1. F. Bruder Stapleton, MD

Artificially elevated oximetry readings resulted in fewer hospitalizations.

  1. F. Bruder Stapleton, MD

Pulse oximetry measurement of 90% to 95% is one criterion used to determine the need for hospitalization in infants with bronchiolitis. To examine the effect of pulse oximetry reading on hospitalization, researchers in Canada randomized 213 children (age range, 4–12 months) in the emergency department (ED) with mild-to-moderate bronchiolitis (oxygen saturation ≥88%) and no other comorbidities to undergo pulse oximetry with true oxygen saturation readings or readings that were artificially elevated by 3%.

Significantly more infants in the true-oximetry group than in the elevated-oximetry group were hospitalized within 72 hours (41% vs. 25%). Among infants with triage oxygen saturations <94%, 6 of 11 and 11 of 17 infants, respectively, were discharged home at the index ED visit, and none were hospitalized within 72 hours. No child required intensive care. In sensitivity analysis, adjustment for reported oxygenation values showed no association between hospitalization and study group. Length of ED stay, use of supplemental oxygen, and rates of subsequent unscheduled visits were similar in the two groups.

Comment

These data remind us that oxygen saturation is only one of several criteria that should determine the need for hospitalization in infants with mild-to-moderate bronchiolitis. The results suggest that overemphasis on oximetry results in unnecessary hospitalizations. An accompanying editorial raises legitimate ethical questions about the study design but concedes that great care was given to assure patient safety.

  • Disclosures for F. Bruder Stapleton, MD at time of publication Grant / research support NIH-NCI Editorial boards UpToDate

Citation(s):

Reader Comments (1)

FAZEL REHMAN MBBS Other, Family Medicine/General Practice, Hyderabad,India

Pulse oximetry is the basic investigation whre you can identify the condition of the patient and severity of the disease.It saves life and helps you to plan management in a organized way

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