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Inpatient Oxygen Therapy to Maintain an Oxygen Saturation Greater or Equal to 90%

Bronchiolitis team recommendation: The Bronchiolitis Team recommends using supplemental oxygen to maintain an oxygen saturation ≥ 90%, based on the American Academy of Pediatrics (AAP, 2006) statement for the care of the patient with bronchiolitis. Per the AAP statement, tolerance of oxygen saturation in the low 90% is influenced by acidosis, some hemoglobinopathies, correct position of the O2 saturation probe, temporal relation to the last nasal clearance of secretions, and the infant's work of breathing. Oxygen supplementation may be administered when oxygen saturation is greater than 90% if any of these factors are present. We placed a high value on assuring the comfort of the infant.

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.