[Medscape] Oxygen desaturation is common in neonates with acute bronchiolitis


Oxygen desaturation is common in infants with acute bronchiolitis, especially those with a more severe onset of the disease, reported the report. by researchers from Switzerland.

Natural oxygen desaturation in infants with acute bronchiolitis is ambiguous, note Dr. Fabiola Stollar and colleagues with the University Hospital of Geneva in their JAMA Network Open paper. .
The researchers evaluated the frequency, duration, risk factors, and symptoms of oxygen desaturation in 239 healthy neonates (mean age 3.9 months) with manifestations present acute bronchiolitis and normal oxygen saturation when present.
Oxygen desaturation (study defined with a SpO2 desaturation lower than 90% for at least one minute or more) occurred in 165 neonates (69%). Rates of desaturation were similar in most infants on admission (137 out of 200, 68.5%) and in children of the same age who were returned home (28 out of 39, range 71, 8%).
The average time to desaturation was 3.6 hours.
The only independent risk factor for desaturation was in patients whose initial clinical presentation was moderate to severe shrinkage (95% CI: 1.49 to 5.02; P = 0.001). .
Of the 39 neonates discharged, more than half (56.4%) had severe hypoxia (recurrent, persistent, or sustained desaturation).
However, in desaturated neonates, including those with large levels of reduction, these infants also did not have a higher rate of re-hospitalization compared with other normal infants (8 of 28 Infants, 28.5% versus 3 of 11 Children, 27.3%). These studies are remarkable because, according to research, infants who have been hospitalized with desaturation may already have undergone a variety of medical interventions.
“Currently, the decision whether to hospitalized with children with bronchiolitis is influenced mainly by saturation measured using pulse oximetry, although diagnostic value is somewhat problematic in determining determine disease severity,” Dr. Stollar and colleagues point out in their paper.
“Many studies have shown that relying on oximetry as a key determinant of hospital admission decisions for infants with bronchiolitis, is associated with significantly increased costs, harm to patients and hospitalization rates”.
Dr. Stollar and colleagues say that the decision to discharge or hospitalized should be based on clinical presentation rather than on SpO2 values ​​alone.
“Patients with respiratory failure should be hospitalized. However, as reported in a 2016 study and a 2015 study, infants with bronchiolitis were considered appropriate for home treatment based on respiratory and hydration status, they should not undergo further oxidation,” they suggest.
“Missed desaturation may not be clinically important. Caregivers should be advised to re-admit the patient to the hospital for re-evaluation if respiratory failure worsens or if the infant is eating less than 50% of the recommended daily nutritional intake,” they added.
The research was supported by the Ernst et Lucie Schmidheiny Foundation and the research and development project fund of the University of Geneva. Dr. Stollar was unavailable for comment by press time.
Link to the original post: www.medscape.com/viewarticle/943313
SOURCE: http://bit.ly/2L2fvbO JAMA Network Open.
Frequency, Timing, Risk Factors, and Outcomes of Desaturation in Infants With Acute Bronchiolitis and Initial Normal Oxygen Saturation
Fabiola Stollar, MD, PhDfirst ; Alban Glangetas, MD2; Fanny Luterbacher, MD2; et alAlain Gervaix, MD2; Constance Barazzone-Argiroffo, MD3; Annick Galetto-Lacour, MD2

Author Affiliations Article Information

JAMA Netw Open. 2020;3(12):e2030905. doi:10.1001/jamanetworkopen.2020.30905
Translator: Gia Tan

Self-translated and edited article at ykhoa.org, please do not reup!

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