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

Pulse oximetry drives overtreatment in children with bronchiolitis without improving clinical outcomes, argue Ricardo Quinonez and colleagues.

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