This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (9)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Pediatrics, Other  • Alert me on articles by topic

Alan R. Schroeder, MD; Andrea K. Marmor, MD; Robert H. Pantell, MD; Thomas B. Newman, MD, MPH

Arch Pediatr Adolesc Med. 2004;158:527-530.

Background  Infants hospitalized with bronchiolitis are frequently monitored with a pulse oximeter. However, there is little consensus on an acceptable lower limit of oxygenation. No previous studies have examined how the use of pulse oximetry and supplemental oxygen therapy affects length of stay.

Objective  To determine the extent to which bronchiolitis hospitalizations are prolonged by a perceived need for supplemental oxygen based on pulse oximetry readings.

Design and Patients  Retrospective case series of subjects younger than 2 years who were hospitalized with bronchiolitis at an academic medical center. Two investigators independently reviewed the hospitalization records of 73 infants and determined at what point an infant met all discharge criteria except oxygenation. We then calculated the extent to which hospitalizations were prolonged by a perceived need for supplemental oxygen therapy based on pulse oximetry readings alone.

Results  Sixty-two infants met inclusion criteria. There was high interrater reliability in determining whether hospitalizations were prolonged ( = 0.75). In 16 (26%) of 62 patients (95% confidence interval, 15%-37%), the hospitalization was prolonged because of oxygenation concerns. Length of stay was prolonged an average of 1.6 days (range, 1.1-2.0 days) per hospitalization for these 16 patients, or 0.4 day (range, 0.2-0.6 day) per hospitalization for all 62 patients.

Conclusions  Hospitalizations of some infants with bronchiolitis are prolonged by a perceived need for supplemental oxygen therapy based on pulse oximetry readings. Further investigation into outcomes of different levels and durations of oxygen desaturation is needed and would have the potential to reduce practice variability and shorten the length of stay.

From the Division of General Pediatrics, Department of Pediatrics (Drs Schroeder, Marmor, Pantell, and Newman), and the Department of Epidemiology and Biostatistics (Dr Newman), University of California–San Francisco.

RELATED ARTICLE

Pulse Oximetry: Good Technology Misapplied
Abraham B. Bergman
Arch Pediatr Adolesc Med. 2004;158(6):594-595.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Effect of Oxygen Supplementation on Length of Stay for Infants Hospitalized With Acute Viral Bronchiolitis
Unger and Cunningham
Pediatrics 2008;121:470-475.
ABSTRACT | FULL TEXT  

Overtreatment in threshold and developed countries
Frey
Arch. Dis. Child. 2008;93:260-263.
ABSTRACT | FULL TEXT  

Oxygen Therapy for Bronchiolitis
Lieberthal
Pediatrics 2007;120:686-687.
FULL TEXT  

Diagnosis and Management of Bronchiolitis
Subcommittee on Diagnosis and Management of Bronch
Pediatrics 2006;118:1774-1793.
ABSTRACT | FULL TEXT  

A Randomized Trial of Home Oxygen Therapy From the Emergency Department for Acute Bronchiolitis
Bajaj et al.
Pediatrics 2006;117:633-640.
ABSTRACT | FULL TEXT  

Use of Serum Electrolyte Panels in Gastroenteritis
Rhee and Silverstein
Pediatrics 2005;115:1108-1109.
FULL TEXT  

Pulse Oximetry May Unnecessarily Prolong Hospital Stay for Bronchiolitis
Schenkman
AAP Grand Rounds 2004;12:27-27.
FULL TEXT  

Role of Pulse Oximetry in Hospital Stays for Infants with Bronchiolitis
JWatch General 2004;2004:4-4.
FULL TEXT