Effect of Oximetry on Hospitalization in Bronchiolitis

Schuh, Suzanne; Freedman, Stephen B.; Coates, Allan L.; Allen, Upton; Parkin, Patricia C.; Stephens, Derek; Ungar, Wendy J.; DaSilva, Zelia; Willan, Andrew R.

doi:10.1001/jama.2014.8637

Cited by 96 publications

(103 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, this recommendation has been criticized. 26,27 Additionally, interobserver agreement is an important issue when calculating CSS values for bronchiolitis patients. 28 We found that the BNP level at the time of admission to the ED yielded objective and accurate information on bronchiolitis severity and morbidity in children.…”

Section: Discussionmentioning

confidence: 99%

B-type natriuretic peptide is a useful biomarker predicting disease severity in children with isolated bronchiolitis in the emergency department

Anıl¹,

Göç²,

Avcı³

et al. 2017

Turk J Pediatr

View full text Add to dashboard Cite

The aim of the study was to determine whether the B-type natriuretic peptide (BNP) plasma level predicted the severity of bronchiolitis without additional pathology in children admitted to an emergency department (ED). A total of 232 children (mean age: 7.7±1.2 months [range: 1-23 months]) presenting to ED with isolated bronchiolitis and 32 age-and gender-matched control subjects were included in the study. BNP levels differed significantly among the control (8.5±1.1 pg/ml) and mild (27.7±2.6 pg/ml), moderate (51.4±0.5 pg/ml), and severe (106.8±4.8 pg/ml) bronchiolitis groups (p<0.001). Clinical severity score (p<0.001; OR: 2.524; 95% CI: 1.826-3.487) and plasma BNP level (p<0.001; OR: 2.231; 95% CI: 1.583-3.242) were independent risk factors for hospitalization. The length of hospital stay was significantly correlated with BNP level (p<0.001; r: 0.698). In conclusion, the plasma BNP level may be a potent biomarker predicting disease severity in ED.

show abstract

Section: Discussionmentioning

confidence: 99%

B-type natriuretic peptide is a useful biomarker predicting disease severity in children with isolated bronchiolitis in the emergency department

Anıl¹,

Göç²,

Avcı³

et al. 2017

Turk J Pediatr

View full text Add to dashboard Cite

show abstract

“…30 The previous study suggesting decreased LOS noted lack of a standard oxygen saturation for initiating supplemental oxygen in the earlier study, leading to prolonged LOS 2 ; we use 90% as a cutoff for initiating supplemental oxygen at our center. Although multiple studies have demonstrated that oxygen saturation influences admission rates, 31,32 other factors such as poor oral intake and need for aggressive suctioning may be important drivers of LOS. Studies have described an association between decreased oral intake and nasal suctioning with LOS in infants with bronchiolitis, [33][34][35] and our interventions did not have any impact on suctioning practices or improving oral intake for patients.…”

Section: Discussionmentioning

confidence: 99%

Using Quality Improvement to Reduce Continuous Pulse Oximetry Use in Children With Wheezing

Schondelmeyer¹,

Simmons²,

Statile³

et al. 2015

Pediatrics

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: Clinicians commonly use continuous pulse oximetry (CPOx) for hospitalized children with respiratory illnesses. The Choosing Wisely initiative recommended discontinuing CPOx for children on room air. We used quality improvement methods to reduce time on CPOx in patients with wheezing.METHODS: Our project took place on 1 unit of a children's hospital. We developed consensus-based criteria for CPOx discontinuation. Interventions included education, a checklist used during nurse handoff, and discontinuation criteria incorporated into order sets. We collected data on a second unit where we did not actively intervene to assess for secular trends and negative consequences of shorter monitoring. We followed time until medically ready, ICU transfers, hospital revisits, and medical emergency team calls on both units. We tracked the impact of interventions by using run charts and statistical process control charts.

show abstract

“…A study illustrating this conundrum was recently published. 19 Treatment of 108 infants with symptoms of mild-to-moderate bronchiolitis and a true saturation of 88% or more presenting to an emergency room in a Toronto hospital were studied. Researchers were evaluating the effect that oximetry measurements during pulse oximetry monitoring had on care decisions while patients were being evaluated for treatment and/or hospital admission in the emergency department.…”

Section: Confusion Arises When Monitors Are Used To Make a Diagnosismentioning

confidence: 99%

Physiologic Monitoring: Improving Safety or Increasing Risk?

Durbin

2016

Respir Care

View full text Add to dashboard Cite

This paper will present a focused and personal history of physiologic monitoring, beginning with the discovery of modern anesthesia and its development from a technical practice to a scientific discipline. Emphasis will be on the essence of monitoring in the anesthesia evolution, and this work will attempt to answer the question of how to evaluate the impact of monitoring on patient outcome. Understanding that monitors are passive and that only caregivers using monitors can impact outcome is at the crux of this approach to analysis. The limited quality data involving monitoring analysis, including that from pulse oximetry, will be discussed and critiqued. The invention and rapid spread of pulse oximetry will be highlighted and used as an example throughout, but the principles developed will apply to other monitors and patient monitoring in general. The problems created by monitoring alarms will also be discussed.

show abstract

Effect of Oximetry on Hospitalization in Bronchiolitis

Abstract: clinicaltrials.gov Identifier: NCT00673946.

Cited by 96 publications

References 25 publications

B-type natriuretic peptide is a useful biomarker predicting disease severity in children with isolated bronchiolitis in the emergency department

B-type natriuretic peptide is a useful biomarker predicting disease severity in children with isolated bronchiolitis in the emergency department

Using Quality Improvement to Reduce Continuous Pulse Oximetry Use in Children With Wheezing

Physiologic Monitoring: Improving Safety or Increasing Risk?

Contact Info

Product

Resources

About