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

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.