Related Experiment Video
Updated: Nov 24, 2025
How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children
Published on: August 19, 2020
Frequency, Timing, Risk Factors, and Outcomes of Desaturation in Infants With Acute Bronchiolitis and Initially
Fabiola Stollar1, Alban Glangetas2, Fanny Luterbacher2
1General Pediatric Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
Insights
Oxygen desaturation is common in infants with acute bronchiolitis, occurring in nearly 70% of cases. Severe initial symptoms are the main risk factor, but desaturation does not increase rehospitalization risk for discharged infants.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Clinical Research
Background:
- Acute bronchiolitis is a common pediatric respiratory illness.
- Understanding oxygen desaturation patterns and risk factors is crucial for effective management and hospitalization decisions.
Purpose of the Study:
- To determine the frequency and timing of oxygen desaturation in infants with acute bronchiolitis.
- To identify risk factors associated with desaturation.
- To compare outcomes between hospitalized and discharged infants, including rehospitalization rates.
Main Methods:
- A prospective cohort study involving 239 infants under 1 year with acute bronchiolitis and initial oxygen saturation >=90%.
- Continuous pulse oximetry monitoring for up to 36 hours.
- Analysis of clinical presentation, hospitalization status, and rehospitalization data.
Main Results:
- Desaturation (SpO2 <90%) occurred in 69% of infants within 3.6 hours.
- Hospitalized and discharged infants showed similar desaturation rates.
- Severe retractions were the only independent risk factor for desaturation.
- Desaturation did not increase rehospitalization risk for infants discharged home.
Conclusions:
- High rates of oxygen desaturation are observed in infants with acute bronchiolitis, irrespective of hospitalization.
- Clinical severity, specifically retractions, is a key predictor of desaturation.
- Routine desaturation monitoring in discharged infants may not be necessary to predict rehospitalization.
Importance:
Little is known about the natural course of oxygen desaturation in acute bronchiolitis. Information on risk factors associated with desaturation as well as the time to desaturation in infants with bronchiolitis could help physicians better treat these infants before deciding whether to hospitalize them.
Objective:
To prospectively determine the frequency of desaturation in infants with bronchiolitis, along with the time to desaturation and risk factors associated with desaturation, and to compare infants who were hospitalized with those discharged home and evaluate risk factors for rehospitalization.
Design, Setting, And Participants:
This cohort study was conducted during the 2017 to 2018 and 2018 to 2019 respiratory syncytial virus seasons in a tertiary care pediatric emergency department in Switzerland. Included individuals were 239 otherwise-healthy infants aged younger than 1 year, diagnosed with acute bronchiolitis and oxygen saturation of 90% or more on arrival. Data were analyzed from July 2019 to October 2020.
Exposures:
After receiving triage care, study participants admitted to the emergency department were equipped with a pulse oximeter to continuously record oxygen saturation (Spo2 levels), regardless of subsequent hospitalization or discharge home.
Main Outcomes And Measures:
The primary outcome was desaturation (ie, Spo2 < 90%) during the first 36 hours.
Results:
Of 239 infants enrolled, with a median (interquartile range [IQR]) age of 3.9 (1.5-6.5) months, 116 (48.5%) were boys and desaturation occurred in 165 infants (69.0%). Median (IQR) time to desaturation was 3.6 (1.8-9.4) hours. The rate of desaturation was similar between infants hospitalized and those discharged home (137 of 200 infants [68.5%] vs 28 of 39 infants [71.8%]; difference, -3.3%; 95% CI, -18.8% to 12.2%; P = .85). A more severe initial clinical presentation with moderate or severe retractions was the only independent risk factor associated with desaturation (odds ratio, 2.73; 95% CI, 1.49 to 5.02; P = .001). Of 39 infants discharged home, 22 infants (56.4%) experienced major desaturations. However, infants with desaturations, including those with major desaturations, had rates of rehospitalization similar to those of infants without desaturations (8 of 28 infants [28.5%] vs 3 of 11 infants [27.3%]; difference, 1.2%; 95% CI, -29.9% to 32.5; P > .99).
Conclusions And Relevance:
These findings suggest that rates of desaturation in infants with acute bronchiolitis were high and similar between infants who were hospitalized and those discharged home. A more severe initial clinical presentation was the only risk factor associated with desaturation. However, for infants discharged home, desaturation was not a risk factor associated with rehospitalization.
More Related Videos
Related Concept Videos
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:26Respiratory Volumes and Capacities I
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:23Acute Respiratory Failure-IV