Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial

Summary Background The American Academy of Pediatrics recommends a permissive hypoxaemic target for an oxygen saturation of 90% for children with bronchiolitis, which is consistent with the WHO recommendations for targets in children with lower respiratory tract infections. No evidence exists to sup...

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Published in:	The Lancet (British edition) 2015-09, Vol.386 (9998), p.1041-1048
Main Authors:	Cunningham, Steve, Dr, Rodriguez, Aryelly, MSc, Adams, Tim, MBChB, Boyd, Kathleen A, PhD, Butcher, Isabella, PhD, Enderby, Beth, MD, MacLean, Morag, PhD, McCormick, Jonathan, MD, Paton, James Y, MD, Wee, Fiona, BSc, Thomas, Huw, FRCPCH, Riding, Kay, MSc, Turner, Steve W, MD, Williams, Chris, MB BCh, McIntosh, Emma, PhD, Lewis, Steff C, Prof
Format:	Article
Language:	eng
Subjects:	Babies Bronchiolitis, Viral - blood Bronchiolitis, Viral - complications Bronchiolitis, Viral - therapy Clinical outcomes Clinical trials Cost estimates Cough - virology Double-Blind Method Female Hospitalization Humans Infant Infections Internal Medicine Length of Stay - statistics & numerical data Male Oximetry - methods Oxygen Oxygen - blood Oxygen Inhalation Therapy - adverse effects Oxygen Inhalation Therapy - methods Oxygen therapy Partial Pressure Respiratory diseases Treatment Outcome
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Summary:	Summary Background The American Academy of Pediatrics recommends a permissive hypoxaemic target for an oxygen saturation of 90% for children with bronchiolitis, which is consistent with the WHO recommendations for targets in children with lower respiratory tract infections. No evidence exists to support this threshold. We aimed to assess whether the 90% or higher target for management of oxygen supplementation was equivalent to a normoxic 94% or higher target for infants admitted to hospital with viral bronchiolitis. Methods We did a parallel-group, randomised, controlled, equivalence trial of infants aged 6 weeks to 12 months of age with physician-diagnosed bronchiolitis newly admitted into eight paediatric hospital units in the UK (the Bronchiolitis of Infancy Discharge Study [BIDS]). A central computer randomly allocated (1:1) infants, in varying length blocks of four and six and without stratification, to be clipped to standard oximeters (patients treated with oxygen if pulse oxygen saturation [SpO2 ]
ISSN:	0140-6736 1474-547X