Oxygen treatment of acute bronchiolitis
Abstract
Acute bronchiolitis is the most common lower respiratory tract infection in children under two years of age. Treatment of acute bronchiolitis is supportive, i.e. application of oxygen to children with hypoxaemia and care for proper hydration. The value obtained by pulse oximetry is merely an indirect measurement of the actual oxygen level in the blood and does not reflect the severity of the disease. By the application of oxygen we only correct hypoxaemia, but do not treat the underlying cause. Nevertheless, as there is no clinical sign that would precisely define children with hypoxaemia, pulse oximetry remains the decisive investigation in decision-making about oxygen application. Studies have shown that when assessing the severity of the disease, pediatricians trust the values of oxygen saturation (SpO2) rather than the clinical assessment. Since pulse oximetry has been in use, the percentage of hospitalised patients due to acute bronchiolitis has increased by about 250 %. Guidelines for treating children with acute bronchiolitis are not consistent in terms of specifying a SpO2 cut-off value that requires oxygen therapy. In this review we have critically evaluated these guidelines and presented our own experience regarding oxygen treatment of acute bronchiolitis.
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