In this issue of the ARCHIVES, Schroeder et al1 show that the hospital stays of 16 of 62 infants with bronchiolitis were prolonged an average of 1.6 days because of a perceived need for supplemental oxygen based on pulse oximetry readings. In an earlier study based on a survey of the practices of 118 pediatric emergency medicine physicians, Mallory et al2 suggest that reliance on pulse oximetry might be responsible for the 250% increase in bronchiolitis hospitalization rates seen during the past 20 years. It seems therefore that using pulse oximetry as a fifth vital sign, as it is termed,3 gets more infants with bronchiolitis into hospitals and keeps them there longer. Have the outcomes of infants with bronchiolitis been improved by this practice? Not that anyone can tell. Mortality rates for bronchiolitis have remained relatively constant for the past 2 decades.4
Bergman AB. Pulse Oximetry: Good Technology Misapplied. Arch Pediatr Adolesc Med. 2004;158(6):594–595. doi:10.1001/archpedi.158.6.594
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