Abstract
Acute bronchiolitis has been associated with an increasing hospitalization rate over the past decades. The aim of this paper was to estimate the impact of home oxygen therapy (HOT) on hospital stay for infants with acute bronchiolitis. A retrospective cohort study was done including all children aged ≤12 months discharged from a pediatric tertiary-care center with a diagnosis of bronchiolitis, between November 2007 and March 2008. Oxygen was administered according to a standardized protocol. We assumed children with the following criteria could have been sent home with O2, instead of being kept in hospital: age ≥2 months, distance between home and hospital <50 km, in-hospital observation ≥24 h, O2 requirement ≤1.0 L/min, stable clinical condition, no enteral tube feeding, and intravenous fluids <50 mL/kg/day. Children with significant underlying disease were excluded. A total of 177 children were included. Median age was 2.0 months (range 0–11), and median length of stay was 3.0 days (range 0–18). Forty-eight percent of patients (85/177) received oxygen during their hospital stay. Criteria for discharge with HOT were met in 7.1 % of patients, a mean of 1.8 days (SD 1.8) prior to real discharge. The number of patient-days of hospitalization which would have been saved had HOT been available was 21, representing 3.0 % of total patient-days of hospitalization for bronchiolitis over the study period (21/701). Conclusions: In this study setting, few children were eligible for an early discharge with HOT. Home oxygen therapy would not significantly decrease the overall burden of hospitalization for bronchiolitis.
Similar content being viewed by others
Abbreviations
- ED:
-
Emergency department
- HOT:
-
Home oxygen therapy
- PICU:
-
Pediatric intensive care unit
References
American Academy of Pediatrics (2006) Diagnosis and management of bronchiolitis. Pediatrics 118:1774–1793
Bajaj L, Turner CG, Bothner J (2006) A randomized trial of home oxygen therapy from the emergency department for acute bronchiolitis. Pediatrics 117:633–640
Balfour-Lynn IM (2009) Domiciliary oxygen for children. Pediatr Clin North Am 56:275–296
Cunningham S (2009) “A hospital is no place to be sick” Samuel Goldwyn (1882–1974). Arch Dis Child 94:565–566
Fouzas S, Priftis KN, Anthracopoulos MB (2011) Pulse oximetry in pediatric practice. Pediatrics 128:740–752
Garcia CG, Bhore R, Soriano-Fallas A, Trost M, Chason R, Ramilo O, Mejias A (2010) Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis. Pediatrics 126:e1453–e1460
Halstead S, Roosevelt G, Deakyne S, Bajaj L (2012) Discharged on supplemental oxygen from an emergency department in patients with bronchiolitis. Pediatrics 129:e605–e610
Joseph L, Goldberg S, Picard E (2006) A randomized trial of home oxygen therapy from the emergency department for acute bronchiolitis (letter). Pediatrics 118:1319–1320
Mallory MD, Shay DK, Garrett J, Bordley WC (2003) Bronchiolitis management preferences and the influence of pulse oximetry and respiratory rate on the decision to admit. Pediatrics 111:e45–e51
Pelletier AJ, Mansbach JM, Camargo CA Jr (2006) Direct medical costs of bronchiolitis hospitalizations in the United States. Pediatrics 118:2418–2423
Perlstein PH, Kotagal UR, Bolling C, Steele R, Schoettker PJ, Atherton HD, Farrell MK (1999) Evaluation of an evidence-based guideline for bronchiolitis. Pediatrics 104:1334–1341
Samuels MO (2004) The effects of flight and altitude. Arch Dis Child 89:448–455
Sandweiss DR, Corneli HM, Kadish HA (2010) Barriers to discharge from a 24-h observation unit for children with bronchiolitis. Pediatr Emerg Care 26:892–896
Schroeder AR, Marmor AK, Pantell RH, Newman TB (2004) Impact of pulse oximetry and oxygen therapy on length of stay in bronchiolitis hospitalizations. Arch Pediatr Adolesc Med 158:527–530
Schuh S (2011) Update on management of bronchiolitis. Curr Opin Pediatr 23:110–114
Shay DK, Holman RC, Newman RD, Liu LL, Stout JW, Anderson LJ (1999) Bronchiolitis-associated hospitalizations among US children, 1980–1996. JAMA 282:1440–1446
Tie SW, Hall GL, Peter S, Vine J, Verheggen M, Pascoe EM, Wilson AC, Chaney G, Stick SM, Martin AC (2009) Home oxygen for children with acute bronchiolitis. Arch Dis Child 94:641–643
Walker C, Danby S, Turner S (2012) Impact of a bronchiolitis clinical care pathway on treatment and hospital stay. Eur J Pediatr 171:827–832
Zorc JJ, Hall CB (2010) Bronchiolitis: recent evidence on diagnosis and management. Pediatrics 125:342–349
Conflict of interest
The authors declare that they have no conflict of interest. They did not have any affiliation, financial agreement, or other involvement with any company for this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gauthier, M., Vincent, M., Morneau, S. et al. Impact of home oxygen therapy on hospital stay for infants with acute bronchiolitis. Eur J Pediatr 171, 1839–1844 (2012). https://doi.org/10.1007/s00431-012-1831-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00431-012-1831-4