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Oxygen saturation thresholds in bronchiolitis: examining admissions
  1. Tim J van Hasselt1,
  2. Bhavna Singham2,
  3. Eve Bassett3,
  4. Ian D Wacogne3,
  5. Paediatric Research Across the Midlands (PRAM) Network
  1. 1 Department of General Paediatrics, Walsall Manor Hospital, Walsall, UK
  2. 2 Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
  3. 3 Department of General Paediatrics, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Tim J van Hasselt, General Paediatrics, Walsall Manor Hospital, Walsall WS2 9PS, UK; t.vanhasselt{at}nhs.net

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.

  • bronchiolitis
  • paediatrics

https://doi.org/10.1136/archdischild-2019-317683

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    Footnotes

    • Collaborators Dr Bhavna Singham; Dr Andy Taylor; Dr Vic Parsonson; Dr Harriet Swallow; Dr Joanna Nuthall; Dr Sonia Goyal; Dr Hannah Cooper; Dr Katy Francis; Dr Isobel Fullwood; Dr Liz Fairholme; Dr Prasadi Desilva; Dr Deevena Chinthala; Dr Kun Hu; Dr Fiona Halton; Dr Nabil Fassaludhin; Dr Ceri-Louise Chadwick. All affiliated to Paediatric Research Across the Midlands.

    • Contributors TJvH was involved in project design, statistical analysis and manuscript. BS was involved in project design and liaison with local data collectors. EB was involved in project design. IW was involved with project design. All authors reviewed and approved final manuscript. BS, AT, VP, HS, JN, SG, HC, KF, IF, LF, PD, DC, KH, FH, NF and CC are PRAM affiliated local collaborators, led the project locally at each site: registered with governance, collected and reviewed local data.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.