742. Evaluating Intermittent Pulse Oximetry Use In Non-hypoxemic Hospitalized Bronchiolitis Patients
Session: Oral Abstract Session: The NICU and Beyond
Friday, October 9, 2015: 11:30 AM
Room: 32--ABC
Background: Pulse oximetry is routinely used to monitor infants and children hospitalized with respiratory diagnoses. In bronchiolitis care, it has been hypothesized that oxygen saturation is the critical element in determining clinicians decisions about the necessity of hospitalization. Oxygen saturation has been implicated as a prime determinant of length of stay in these patients as well. Despite studies asserting the importance of the parameter to the care of the disease, no study has yet linked routine use of pulse oximetry to improved outcomes in bronchiolitis.

Objective:  To determine the impact of intermittent pulse oximetry monitoring on clinical outcomes and use of supportive care measures for non-hypoxic children hospitalized with bronchiolitis.

Methods: Multi-site, randomized trial of otherwise healthy infants ≤2 years of age hospitalized with bronchiolitis.  Patients were randomized to undergo continuous pulse oximetry monitoring or “spot checks” during hospitalization when oxygen saturations were ≥90%.  Length of hospital stay, use of healthcare interventions, and significant clinical events were compared between study arms.

Results: A total of 161 patients were enrolled in the study (80 patients continuous monitoring, 81 patients intermittent).  Rates of performance of laboratory studies, therapies, and procedures did not differ between the two groups.  Use of nasopharyngeal suctioning and duration of supplemental oxygen use did not differ between study arms.  Median length of stay did not differ based on pulse oximetry monitoring strategy (38.7 [IQR: 23.6-64.7] hours continuous monitoring vs 39.5 [IQR: 24.3-59.5] hours intermittent monitoring, p=0.77).  Prevalence of transfer to an intensive care unit setting did not differ between the two groups.  There were no deaths among enrolled patients.

Conclusion: Intermittent pulse oximetry monitoring of non-hypoxemic hospitalized bronchiolitis patients does not shorten hospital length of stay and is not associated with any differences in clinical practice patterns.  Given its greater ease of use and lower risk of alarm fatigue, intermittent pulse oximetry monitoring should be routinely considered in the management of children hospitalized with mild bronchiolitis.

Gina Weddle, DNP, RN, CPNP, Infectious Disease, The Children's Mercy Hospital, Kc, MO, Russell Mcculloh, MD, Pediatrics, Division of Pediatric Infectious Disease, Hasbro Childrens Hospital, Brown University, Providence, RI, Michael Koster, MD, Schneider Children's Hospital of the North Shore-Long Island Jewish Health System, Manhasset, NY, Matthew Johnson, MD, Children's Mercy Hospital, Kansas City, MO, Vanessa Hill, MD, Children's Hospital of San Antonio, San Antionio, TX, Kristin Koehn, MD, University of Missouri Women and Children's Hospital, Columbia, MO, Shawn Ralston, MD, Children's Hospital at Dartmouth, Lebanon, NH and Brian Alverson, MD, Pediatrics, Rhode Island Hospital/Brown University, Providence, RI

Disclosures:

G. Weddle, None

R. Mcculloh, None

M. Koster, None

M. Johnson, None

V. Hill, None

K. Koehn, None

S. Ralston, None

B. Alverson, None

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