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Implementing an Oxygen Supplementation and Monitoring Protocol on Inpatient Pediatric Bronchiolitis: An Exercise in
Brian LeCleir1, Leslie Jurecko2, Alan T Davis3,4
1Forest Hills Pediatrics, Grand Rapids, MI, USA.
Insights
This study found that an oxygen (O2) protocol significantly decreased overall hospital length of stay for children with bronchiolitis, particularly benefiting those with milder cases.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Hospital Management
Background:
- Bronchiolitis is a common respiratory illness in infants.
- Hospital length of stay (LOS) is a key metric for evaluating care efficiency.
- Optimizing oxygen therapy can impact patient outcomes and resource utilization.
Purpose of the Study:
- To assess the effectiveness of a specific oxygen (O2) protocol in reducing LOS for hospitalized children with bronchiolitis.
- To analyze the impact of the O2 protocol on secondary outcomes, including O2 supplementation duration, PICU transfer rates, and readmissions.
Main Methods:
- Retrospective cohort study comparing children on an O2 protocol to historical controls.
- Inclusion criteria: children ≤ 24 months old hospitalized with bronchiolitis.
- Primary outcome: hospital length of stay; secondary outcomes: O2 duration, PICU transfer, readmission rates.
Main Results:
- The O2 protocol group had more severely ill patients but showed no significant difference in mean LOS, PICU transfers, or readmissions compared to controls.
- Multiple regression analysis revealed a significant ~20% decrease in hospitalization length associated with the O2 protocol (p=0.030).
Conclusions:
- The oxygen protocol demonstrated a significant overall reduction in hospital length of stay for pediatric bronchiolitis.
- While increasing LOS in more severely ill patients, the protocol profoundly decreased LOS in milder cases, leading to a net benefit.
Aim:
Our goal in this study is to evaluate the effectiveness of our oxygen (O2) protocol to reduce length of stay (LOS) for children hospitalized with bronchiolitis.
Methods:
In this retrospective cohort study, the outcomes of children ≤ 24 months old that were admitted with bronchiolitis and placed on the O2 protocol were compared to historical controls. The primary outcome was hospital length of stay. Secondary outcomes were duration of O2 supplementation, rates of pediatric intensive care unit transfer, and readmission.
Results:
Groups were not significantly different in age, gender, and rates of respiratory distress score assessment. Significantly more severely ill patients were in the O2 protocol group. There were no significant differences between control and O2 protocol groups with regard to mean LOS, rates of pediatric intensive care unit transfer, or seven-day readmission rates. By multiple regression analysis, the use of the O2 protocol was associated with a nearly 20% significant decrease in the length of hospitalization (p = 0.030).
Conclusion:
Use of O2 supplementation protocol increased LOS in the more ill patients with bronchiolitis but decreased overall LOS by having a profound effect on patients with mild bronchiolitis.
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