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Updated: Apr 22, 2026

Standardized Measurement of Nasal Membrane Transepithelial Potential Difference NPD
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Electrolyte Testing Variability Among Critically Ill Children With Viral Bronchiolitis.

Patrick D Snyder1, Kristen Miller2, Michael Tchou2

  • 1Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, USA.

Cureus
|April 21, 2026
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Summary
This summary is machine-generated.

Pediatric intensive care unit (PICU) practices for electrolyte testing in infants with viral bronchiolitis vary significantly across U.S. hospitals. This study highlights widespread differences in testing frequency and repeat testing, indicating a need for standardized guidelines.

Keywords:
high-value carenational trendpediatric critical care usapedictric intensive care unit (picu)viral bronchiolitis

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Area of Science:

  • Pediatric critical care medicine
  • Clinical practice variation
  • Health services research

Background:

  • Viral bronchiolitis is a leading cause of pediatric hospitalization for infants.
  • Rising critical bronchiolitis admissions and costs necessitate understanding care practices.
  • Electrolyte testing patterns in pediatric intensive care units (PICUs) for bronchiolitis are not well-defined.

Purpose of the Study:

  • To evaluate the frequency of electrolyte testing in U.S. PICUs for children with viral bronchiolitis.
  • To assess the extent of variation in electrolyte testing practices across different PICUs.

Main Methods:

  • Multicenter, retrospective cohort study utilizing the Pediatric Health Information System database.
  • Inclusion of children admitted to PICUs with viral bronchiolitis between January 1, 2017, and December 31, 2021.
  • Primary outcomes: rate of any electrolyte testing and rate of multiple electrolyte testing per hospitalization.

Main Results:

  • Electrolyte testing was performed in 79% of 23,776 patient encounters.
  • Significant between-hospital variation observed in both initial (32% of variation) and repeat testing (44% of variation).
  • Among tested patients, 80% received multiple tests, while 20% received only a single test.

Conclusions:

  • Substantial national variation exists in electrolyte testing practices for PICU patients with viral bronchiolitis.
  • Heterogeneity in current practice highlights the need for further research.
  • Future studies should explore clinical context to define optimal electrolyte testing strategies and their relation to patient outcomes.