Bronchiolitis, an acute viral infection of the lower respiratory tract, is a leading cause of hospitalizations among infants and toddlers.1 The Choosing Wisely campaign and the American Academy of Pediatrics clinical practice guidelines outline an evidence-based, supportive approach to bronchiolitis care, but adoption of these recommendations remains variable.2-4 In particular, a recent cross-sectional study4 of 56 North American hospitals found that guideline-concordant use of continuous pulse oximetry in hospitalized infants with bronchiolitis ranged from 2% to 92%. This variability may stem from the fact that the recommendation is based on evidence from retrospective, nonrandomized studies that found associations between use of continuous pulse oximetry and increased length of stay (LOS), higher costs, and patient harm. It therefore carries the worst evidence-quality grade (D) and weakest recommendation strength of any in the American Academy of Pediatrics guideline.
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Cheston CC, Rutledge R, Hsu HE. Should We Prioritize Deimplementation of Continuous Pulse Oximetry in Bronchiolitis Care? JAMA Pediatr. 2021;175(5):459–461. doi:10.1001/jamapediatrics.2020.6157
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