title: Impact of home oxygen therapy on hospital stay for infants with acute bronchiolitis.
abstract: Acute bronchiolitis has been associated with an increasing hospitalization rate over the past decades. The aim of this paper was to estimate the impact of home oxygen therapy (HOT) on hospital stay for infants with acute bronchiolitis. A retrospective cohort study was done including all children aged ≤ 12 months discharged from a pediatric tertiary-care center with a diagnosis of bronchiolitis, between November 2007 and March 2008. Oxygen was administered according to a standardized protocol. We assumed children with the following criteria could have been sent home with O(2), instead of being kept in hospital: age ≥ 2 months, distance between home and hospital <50 km, in-hospital observation ≥ 24 h, O(2) requirement ≤ 1.0 L/min, stable clinical condition, no enteral tube feeding, and intravenous fluids <50 mL/kg/day. Children with significant underlying disease were excluded. A total of 177 children were included. Median age was 2.0 months (range 0-11), and median length of stay was 3.0 days (range 0-18). Forty-eight percent of patients (85/177) received oxygen during their hospital stay. Criteria for discharge with HOT were met in 7.1 % of patients, a mean of 1.8 days (SD 1.8) prior to real discharge. The number of patient-days of hospitalization which would have been saved had HOT been available was 21, representing 3.0 % of total patient-days of hospitalization for bronchiolitis over the study period (21/701).
  
  
  CONCLUSIONS
  In this study setting, few children were eligible for an early discharge with HOT. Home oxygen therapy would not significantly decrease the overall burden of hospitalization for bronchiolitis.
authors.affiliation: Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Canada. marie.gauthier.hsj@ssss.gouv.qc.ca
authors.forename: Marie
authors.initials: M
authors.lastname: Gauthier
authors.forename: Melanie
authors.initials: M
authors.lastname: Vincent
authors.forename: Sylvain
authors.initials: S
authors.lastname: Morneau
authors.forename: Isabelle
authors.initials: I
authors.lastname: Chevalier
mesh_terms: D000465:Algorithms; D001988:Bronchiolitis / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000379:methods; D010351:Patient Discharge / Q000706:statistics & numerical data; D011792:Quebec; D012189:Retrospective Studies; D016896:Treatment Outcome