Observational study of two oxygen saturation targets for discharge in bronchiolitis.

Cunningham, Steve; McMurray, Ann

OBJECTIVES To assess the potential effect of two guideline discharge oxygen saturation (SpO(2)) recommendations (≥90% and ≥94%) in recovering bronchiolitis. METHODS AND PATIENTS Infants aged up to 18 months requiring therapeutic oxygen for SpO(2) (≤93%) had SpO(2) assessed in air every 2 h. Time from admission to re-establish feeding (>75% normal) and for SpO(2) to become stable for at least 4 h at ≥90% and ≥94% were noted. RESULTS 68 infants, median age 14 weeks, were included. Feeding problems resolved at a median of 11 h (inter-quartile range, IQR 0-47). SpO(2) became stable for at least 4 h at 17 h (IQR 0-49) for ≥90% and 63 h (IQR 34-105) for ≥94%. Time for infants to achieve a stable SpO(2)≥90% and resolve feeding difficulties was a median of 22 h (IQR 7-39 h) sooner than the equivalent for stable SpO(2)≥94%. CONCLUSIONS Accepting lower SpO(2) at discharge could significantly reduce length of stay, but require the clinical and safety effects to be studied.