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When Technology Creates Uncertainty: Pulse Oximetry and Overdiagnosis of Hypoxaemia in Bronchiolitis

Quinonez RA, Coon ER, Schroeder AR, Moyer VA
British Medical Journal
Pub Med #: 

Key Messages

  • Bronchiolitis admissions have increased substantially over the past 30 years, without a concomitant change in disease severity or mortality
  • The increase in admission rates for bronchiolitis coincides with the increased widespread use of pulse oximetry in the 1980s
  • Hypoxaemia may be a main driver for decisions to admit children with bronchiolitis, evidence shows
  • Overdiagnosis of hypoxaemia may be at least partially responsible for increased admission rates of children with bronchiolitis, recent evidence shows
  • Lower thresholds for oxygen concentration to determine treatment may be associated with better outcomes such as decreased length of stay, with no demonstrated evidence of adverse outcomes