Oxygen saturation thresholds in bronchiolitis: examining admissions

Abstract

Objective: Examine admissions for bronchiolitis, comparing centres with oxygen saturation thresholds for admission of 90% versus 92%.

Design: Prospective multi-centre service evaluation, all admissions for bronchiolitis during 4-week period, November 2018.

Setting: Paediatric departments across 12 hospitals in the West Midlands, UK.

Patients: 320 patients aged 6 weeks-1 year, diagnosis of bronchiolitis, exclusions: chronic illness or high dependency/intensive care admission.

Main outcome measures: Reason for admission, admission saturations and length of stay.

Results: Inadequate feeding was the the most common reason for admission (80%). Only 20 patients were admitted solely because of low saturations. Median peripheral oxygen saturation in this group was 88%. Median length of stay in 90% centres was 41 hours, against 59 hours for 92% centres (p=0.0074).

Conclusions: Few patients were admitted solely due to low oxygen saturations, only one had a potentially avoidable admission if thresholds were 90%. Length of stay was significantly reduced in the 90% threshold centres.

Keywords: bronchiolitis; paediatrics.