A new study published in JAMA found that, among infants presenting to a pediatric emergency department with mild to moderate bronchiolitis, those with an artificially elevated oxygen saturation reading were less likely to be hospitalized or receive hospital care for more than 6 hours than those with unaltered readings.
The findings suggest that these readings should not be the only factor in the decision to admit or discharge an infant with a respiratory infection.
Pulse oximetry, which involves an instrument usually attached on the finger or ear lobe, is a noninvasive method of measuring oxygen saturation, and its routine use has been associated with changes in the management of bronchiolitis, a leading cause of infant hospitalizations in the US.
There is no evidence that certain cutoff measurements using pulse oximetry predict progression from relatively mild to severe bronchiolitis, according to background information in the article.
“Artificially increasing the oximetry display in emergency department patients with mild to moderate bronchiolitis by a physiologically small amount significantly reduced hospitalizations within 72 hours or active hospital care for more than 6 hours compared with infants with unaltered oximetry readings. This conclusion also held true after adjustment for other variables significantly associated with this outcome. Because the groups had similar severity and the adjustment for the experimental saturation resulted in lack of primary treatment effect, the difference in displayed saturations was likely the primary reason for the observed reduction in hospitalizations,” the authors write.
The researchers add that these findings suggest “that oxygen saturation should not be the only factor in the decision to admit, and its use may need to be re-evaluated.”