Abstract:IMPORTANCE Clinical practice guidelines for managing infants and children hospitalized for bronchiolitis recommend only obtaining intermittent or "spot check" pulse oximetry readings for those who show clinical improvement. The effect of such monitoring is currently unknown. OBJECTIVE To determine the effect of intermittent vs continuous pulse oximetry monitoring on hospital length of stay among nonhypoxemic infants and young children hospitalized for bronchiolitis. DESIGN, SETTING, AND PARTICIPANTS Randomized… Show more
“…12 Perhaps because of these factors, the RESTORE refusal rate is low compared with other similar pediatric research clinical trials. For example, the RESTORE refusal rate of 23% is better than observed in a trial of pulse oximetry monitoring for bronchiolitis (31%) 16 and markedly better than obtained in a nontherapeutic pediatric ICU cohort study of adrenal insufficiency (58%). 17 However, this low RESTORE refusal rate did not prevent disparities in participation by minority children.…”
“…12 Perhaps because of these factors, the RESTORE refusal rate is low compared with other similar pediatric research clinical trials. For example, the RESTORE refusal rate of 23% is better than observed in a trial of pulse oximetry monitoring for bronchiolitis (31%) 16 and markedly better than obtained in a nontherapeutic pediatric ICU cohort study of adrenal insufficiency (58%). 17 However, this low RESTORE refusal rate did not prevent disparities in participation by minority children.…”
“…22 The authors concluded that intermittent pulse oximetry was safe, in that no differences in escalations of care were seen between groups. Surprisingly, they found no difference in length of stay between groups, perhaps because the intervention was not initiated until children were weaned off oxygen.…”
Section: Randomised Trials Affecting the Probability Of Hypoxaemia DImentioning
“…McCulloh and colleagues 16 in a recently published randomized controlled trial found that intermittent (versus continuous) pulse oximetry did not reduce LOS. Our team also failed to demonstrate a reduced LOS coincident with our QI intervention that decreased time on CPOx after clinical improvement.…”
Reducing continuous pulse oximetry use alone may not make substantial reductions in overall alarm counts. Even on our intervention unit, alarm burden remained quite high.
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