Constant Pulse Oximetry Monitoring Too Much for Infants with Bronchiolitis
Published April 2020 | JAMA
When infants with bronchiolitis do not need supplemental oxygen, they also generally do not need constant measurement of their blood oxygen levels, according to a multi-institutional team of physicians.
Acute viral bronchiolitis is the No. 1 cause of infant hospitalization in the U.S. Treatment includes fluids, suctioning, and supplemental oxygen when necessary. Yet despite recommendations against continuous pulse oximetry monitoring from the American Academy of Pediatrics and the Society of Hospital Medicine, many hospitals still use continuous monitors non-stop.
The result can be an increase in “alarm fatigue” triggered by excessive numbers of false alarms from an unnecessary form of monitoring.
The study was based on information from 56 hospitals in the U.S. and Canada that participate in the Pediatric Research in Inpatient Settings (PRIS) Network. The team found that 46% of infants with bronchiolitis who were not receiving supplemental oxygen were still being monitored via continuous pulse oximetry. The unneeded monitoring ranged from as low as 6% to as high as 82%.
Raising awareness of this wide variation in practice is a first step toward phasing out a common source of false alarms.
The study involved researchers from Children’s Hospital of Philadelphia, Boston Children’s Hospital, Cincinnati Children’s and other institutions. Amanda Schondelmeyer, MD, MSc, was senior author and Patrick Brady, MD, MSc, was a co-author.
While this study involved infants with bronchiolitis, similar analysis is occurring with other common conditions that may involve excessive monitoring. In July 2020, in Pediatrics, Schondelmeyer and colleagues published a set of expert recommendations regarding pulse oximetry monitoring for children hospitalized with mild to moderate asthma and several other conditions.
