Dalla Lana School of Public Health.
Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.
Hosp Pediatr. 2024 Feb 1;14(2):67-74. doi: 10.1542/hpeds.2023-007301.
To examine 2 hospital oxygen saturation target policies and clinical outcomes in infants hospitalized with bronchiolitis.
This multicenter cohort study used data collected from a randomized clinical trial of infants aged 4 weeks to 24 months, hospitalized with bronchiolitis at children's and community hospitals from 2016 to 2019. We modeled the association between hospital oxygen saturation target policy, either 90% while awake and 88% while asleep (90%/88%) or 90% while awake and asleep (90%/90%), and clinical outcomes.
A total of 162 infants were enrolled at 4 hospitals using a 90%/88% oxygen saturation target and 67 infants at 2 hospitals using a 90%/90% target policy. No significant differences between the 90%/88% group and 90%/90% groups were observed for time to discharge (adjusted hazard ratio, 0.83; 95% confidence interval [CI], 0.61-1.14; P = .25), initiation of supplemental oxygen (adjusted odds ratio [aOR], 0.98; 95% CI, 0.47-2.02; P = .95), time to discontinuation of supplemental oxygen (adjusted hazard ratio, 0.75; 95% CI, 0.44-1.27; P = .28), revisits (aOR, 1.38; 95% CI, 0.52-3.71; P = .52), and parent days missed from work (aOR, 2.41; 95% CI, 0.90-6.41; P = .08). Three infants in the 90%/88% group and none in the 90%/90% group were transferred to the ICU.
Among infants hospitalized with bronchiolitis, clinical outcomes were similar between a hospital oxygen saturation target policy of 90% while awake and 88% while asleep compared with 90% while awake and asleep. These findings may inform the design of future trials of oxygen saturation targets in bronchiolitis hospital care.
研究 2 种医院血氧饱和度目标政策与住院毛细支气管炎婴儿的临床结局。
本多中心队列研究使用了 2016 年至 2019 年在儿童医院和社区医院住院的患有毛细支气管炎的 4 周至 24 个月龄婴儿的随机临床试验数据。我们建立了医院血氧饱和度目标政策（清醒时 90%，睡眠时 88%[90%/88%]或清醒和睡眠时均为 90%[90%/90%]）与临床结局之间的关联模型。
共有 162 名婴儿在使用 90%/88%血氧饱和度目标的 4 家医院和 67 名婴儿在使用 90%/90%目标政策的 2 家医院入组。在出院时间（调整后的危险比，0.83；95%置信区间[CI]，0.61-1.14；P=0.25）、开始补充氧气（调整后的优势比[aOR]，0.98；95%CI，0.47-2.02；P=0.95）、停止补充氧气的时间（调整后的危险比，0.75；95%CI，0.44-1.27；P=0.28）、复诊（aOR，1.38；95%CI，0.52-3.71；P=0.52）和父母旷工天数（aOR，2.41；95%CI，0.90-6.41；P=0.08）方面，90%/88%组和 90%/90%组之间没有显著差异。在 90%/88%组中，有 3 名婴儿转至 ICU，而在 90%/90%组中无婴儿转至 ICU。
在住院的毛细支气管炎婴儿中，与清醒时 90%、睡眠时 88%的血氧饱和度目标相比，清醒时和睡眠时均为 90%的目标政策对临床结局没有影响。这些发现可能为未来毛细支气管炎住院治疗中血氧饱和度目标的试验设计提供信息。
