Prevalence of Continuous Pulse Oximetry Monitoring in Hospitalized Children With Bronchiolitis Not Requiring Supplemental Oxygen

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AAP Policy SupplementsSupplements Publish Supplement MultimediaVideo Abstracts Pediatrics On Call Podcast Subscribe Alerts Careers Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health Asthma Prevalence of Continuous Pulse Oximetry Monitoring in Hospitalized Children With Bronchiolitis Not Requiring Supplemental Oxygen Harvey L. Leo Pediatrics December 2020, 146 (Supplement 4) S363; DOI: https://doi.org/10.1542/peds.2020-023861PPP ArticleInfo & MetricsComments Download PDF CP Bonafide, R Xiao, PW Brady. JAMA. 2020;323(15):1467–1477PURPOSE OF THE STUDY:To measure continuous pulse oximetry use in children with bronchiolitis.STUDY POPULATION:A multicenter cross-sectional study was performed in pediatric wards in 56 US and Canadian hospitals in the Pediatric Research in Inpatient Settings Network from December 1, 2018, through March 31, 2019.METHODS:Participants included a convenience sample of patients aged 8 weeks through 23 months with bronchiolitis who were not receiving active supplemental oxygen administration. Patients with extreme prematurity, cyanotic congenital heart disease, pulmonary hypertension, home respiratory support, neuromuscular disease, immunodeficiency, or cancer were excluded.RESULTS:The sample included 3612 patient observations in 33 freestanding children’s hospitals, 14 children’s hospitals within hospitals, and 9 community hospitals. In the sample, 59% were male, 56% were white, and 15% were Black; 48% were aged 8 weeks through 5 months, 28% were aged 6 through 11 months, 16% were aged 12 through 17 months, and 9% were aged 18 through 23 months. The overall continuous pulse oximetry monitoring use percentage in these patients, none of whom were receiving any supplemental oxygen or nasal cannula flow, was 46% (95% CI, 40%–53%). Hospital-level unadjusted continuous pulse oximetry use ranged from 2% to 92%. After risk standardization, use ranged from 6% to 82%. Intraclass correlation coefficient suggested that 27% (95% CI, 19%–36%) of observed variation was attributable to unmeasured hospital-level factors.CONCLUSIONS:In a convenience sample of children hospitalized with bronchiolitis who were not receiving active supplemental oxygen administration, monitoring with continuous pulse oximetry was frequent and varied widely among hospitals. Because of the apparent absence of a guideline or evidence-based indication for continuous monitoring in this population, this practice may represent overuse.REVIEWER COMMENTS:For many clinicians, the treatment of bronchiolitis revolves specifically around supportive care, previous attempts of inhaled steroids, short-acting β-agonists, or oral steroids have been found to be ineffective in shortening hospital stays or clinical outcomes. Even with inpatient observation, it is clear that use of continuous pulse oximetry in children not receiving continuous supplemental oxygen is likely unnecessary, and alternative measures of clinical status should be considered. For clinicians struggling to support families at home, this also may indicate the use of home pulse oximetry measurements by caregivers does not assist in identifying children in true respiratory distress and is likely overused with little benefit.Copyright © 2020 by the American Academy of Pediatrics PreviousNext Back to top Advertising Disclaimer » In this issue Pediatrics Vol. 146, Issue Supplement 4 1 Dec 2020 Table of ContentsIndex by author View this article with LENS PreviousNext Email Article Thank you for your interest in spreading the word on American Academy of Pediatrics.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. 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Leo Pediatrics Dec 2020, 146 (Supplement 4) S363; DOI: 10.1542/peds.2020-023861PPP Citation Manager Formats BibTeXBookendsEasyBibEndNote (tagged)EndNote 8 (xml)MedlarsMendeleyPapersRefWorks TaggedRef ManagerRISZotero Share Prevalence of Continuous Pulse Oximetry Monitoring in Hospitalized Children With Bronchiolitis Not Requiring Supplemental Oxygen Harvey L. Leo Pediatrics Dec 2020, 146 (Supplement 4) S363; DOI: 10.1542/peds.2020-023861PPP Share This Article: Copy Print Download PDF Insight Alerts Table of Contents Jump to section ArticlePURPOSE OF THE STUDY:STUDY POPULATION:METHODS:RESULTS:CONCLUSIONS:REVIEWER COMMENTS:Info & MetricsComments Related ArticlesNo related articles found.Google Scholar Cited By...No citing articles found.Google Scholar More in this TOC SectionAsthma Prescribing Emergency Oral Steroids in Asthma Clinics [published online ahead of print June 11, 2019] The Projected Economic and Health Burden of Uncontrolled Asthma in the United States Effects of Age, Sex, Race/Ethnicity, and Allergy Status in Obesity-Related Pediatric Asthma Show more Asthma Diagnosis and Management Association of Childhood Asthma With Federal Rental Assistance Association Between Bedroom Particulate Matter Filtration and Changes in Airway Pathophysiology in Children With Asthma Show more Diagnosis and Management Similar Articles Journal Info Editorial Board Editorial Policies Overview Licensing Information Authors/Reviewers Author Guidelines Submit My Manuscript Open Access Reviewer Guidelines Librarians Institutional Subscriptions Usage Stats Support Contact Us Subscribe Resources Media Kit About International Access Terms of Use Privacy Statement FAQ AAP.org shopAAP Follow American Academy of Pediatrics on Instagram Visit American Academy of Pediatrics on Facebook Follow American Academy of Pediatrics on Twitter Follow American Academy of Pediatrics on Youtube RSS © 2021 American Academy of Pediatrics

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