19 Aug Pediatric Bronchiolitis: Improved Oxygen Saturation Reduced Hospitalizations
MedicalResearch.com Interview with:
Suzanne Schuh, MD, FRCP(C), FAAP, ABPEM
Staff Paediatrician, Division of Paediatric Emergency Medicine
Senior Associate Scientist, Research Institute, Hospital for Sick Children
Professor of Paediatrics, University of Toronto
Medical Research: What are the main findings of this study?
Dr. Schuh: Our study shows that in previously healthy infants presenting to the Emergency Department with mild to moderate bronchiolitis (a viral lower respiratory tract disease producing breathing distress) who had their oxygen saturation measurements artificially elevated by a physiologically small amount experienced significantly reduced rate of hospitalizations within 72 hours compared to infants with unaltered oximetry readings.
Medical Research: What findings were unexpected?
Dr. Schuh: We were somewhat surprised how a small change of borderline clinical significance in oxygen saturation had a rather large influence on the clinical decision. These results suggest to us that although technology is valuable, good clinical assessment is paramount. There may be other areas in medicine with similar situations and more research needs to be done.
Medical Research: What should patients and clinicians take away from this report?
Dr. Schuh: This study represents one piece of the puzzle in how to put oximetry into clinical perspective. The results tell us that the oxygen saturation should not be the only factor in the decision to admit or discharge and may need to be re-evaluated.
Oxygen saturation should continue to be measured in infants with bronchiolitis but these measurements need to be interpreted within clinical perspective. Among otherwise healthy infants with acute bronchiolitis with saturations 88% and higher, the decision to hospitalize should be based on the degree of respiratory distress, hydration status, availability of close follow up and parental comfort with discharge home, rather than only on a particular oxygen saturation value. There are many reasons which enter into the decision to admit a child with bronchiolitis into hospital and oxygen saturation should be only one part of this decision.
Medical Research: What future research do you recommend as a result of this study?
Dr. Schuh: The low number of infants with low oxygen saturations did not permit us to determine a safe oxygen saturation threshold for safe discharge. Future multi-site studies of infants with low oxygen saturations may help us achieve that goal.