Infants with viral bronchiolitis demonstrate two distinct patterns of nocturnal oxyhaemoglobin desaturation

Abstract

Bronchiolitis was characterised by low nocturnal basal SpO2 and intermittent SpO2 drops.

A graphical method for comparing nocturnal oxygen saturation profiles in individuals and populations: Application to healthy infants and preterm neonates

“…This may be because of the lack of a method to conduct such investigations systematically. This tool, therefore directly addresses this limitation to support studies in neonatal and infant cohorts such as developing more sophisticated titration protocols for oxygen therapy in preterm neonates to better navigate the risks for mortality at low oxygen targets, and retinopathy at high targets (see Online Supplement for further discussion); and improve detection of clinical important hypoxaemia in acute respiratory disease such as bronchiolitis . Additionally, this method also has broader applications in paediatric and adult medicine.…”

“…Given that even healthy infants have desaturation events, the ability to objectively and intuitively quantify not only the SpO 2 distribution and the desaturation incidence but also the desaturation depth and duration, may help to reliably identify pathological SpO 2 profiles. This distinction may be particularly important in the assessment of pathologies such as apnoea of prematurity or obstructive sleep apnoea (OSA) where desaturation characteristics are a direct consequence of the underlying pathology; to assist with guiding therapies and discharge decisions in acute lung disease such as bronchiolitis; and screening to identify congenital heart disease …”

Nocturnal oximetry in pediatric respiratory disease: Urgent need for developing standardized interpretation rules

“…However, no validated approach to the interpretation of oximetry tracings has been used and it is unknown whether movement artifacts have been removed from the analyzed tracings . Bronchiolitis in infancy is associated with two distinct patterns in nocturnal oximetry recordings: reduced baseline SpO 2 and frequent and abrupt SpO 2 drops …”

“…We should note that reference curves based on commercially available devices other than the high‐resolution oximeter with a 2‐second averaging used by Terrill et al might differ from the presented curves. As judiciously shown by the authors in their illustrative examples, although the three types of SpO 2 plots would facilitate the identification of any type of hypoxemia (ie continuous and/or intermittent), inspection of the original oximetry tracing remains fundamental for recognition of the desaturation pattern, and the underlying pathophysiology …”

“…Furthermore, it could facilitate the performance of studies to identify the potential detrimental effects of hypoxemia provided that numerical indices describing the plots for individual patients will be developed for the purposes of statistical comparisons. The previously described cumulative hypoxemia index is such an example . Numerical expression of the area between a pathologic plot and the limit of the reference centile plot (eg 5th or 90th centile) could be another such index.…”