Although current guidelines recommend limited use of continuous pulse oximetry in infants with bronchiolitis, the evidence for this recommendation is weak, and continuous monitoring is still widely practiced. Researchers sought to compare the effect of intermittent (every four hours) and continuous pulse oximetry. They conducted a multicenter randomized clinical trial in hospitalized infants four weeks to 24 months of age who had stabilized bronchiolitis, nearly half of whom received supplemental oxygen. The oxygen saturation target was 90% or higher.

Among the 229 infants enrolled in the study, the median length of hospital stay from randomization to discharge wasn't significantly different between the intermittent monitoring (27.6 hours) and continuous monitoring (25.4 hours) groups. The median length of stay from inpatient unit admission to discharge was also similar between the groups (49.1 and 46 hours, respectively).

No significant differences were found between the groups in terms of medical interventions, such as duration of oxygen supplementation, chest radiography, and blood tests, or safety outcomes, such as ICU transfers, ED revisits, and hospital readmissions. Parent anxiety scores were similar in the two groups, but nursing satisfaction was greater with intermittent monitoring.

The authors note that it wasn't possible to mask the oxygen monitoring intervention in this study. In addition, small differences between groups in the primary outcome of length of stay from randomization to discharge weren't excluded.