Impact of Oximetry on Hospitalization in Acute Bronchiolitis

December 6, 2013 updated by: Suzanne Schuh, The Hospital for Sick Children

Impact of Oximetry on Hospitalization

To determine, in previously healthy infants 6 weeks to 12 months of age, diagnosed with acute bronchiolitis and monitored by hourly oximetry, if the probability of hospitalization within 72 hours of arrival in those whose oxygen saturation display is manipulated 3 percentage points above the true measurements is significantly lower in comparison to those whose monitors display true saturations.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This is the first bronchiolitis study to examine the clinical and economic impact of making disposition decision on primarily clinical grounds, while blinding the physicians to oxygen saturations by providing them with either true saturation measurements or those which are 3 percentage points above the true values. Although physiologically insignificant and within the measurement error of the instrument, this difference has been shown to be perceived as clinically relevant and to have a major hypothetical impact on disposition, without any evidence to support this belief.

We hope to find out if children with oxygen saturations above or in the vicinity of the threshold recommended for initiation of oxygen therapy by the AAP can be safely discharged based on their clinical appearance rather than to have their hospitalization dictated by a locally defined number. This study will hopefully provide much needed evidence necessary to help us interpret the oximetry results more meaningful which may in turn lead to fewer hospitalizations, shorter length of hospital stay and lower health care costs.

Study Type

Interventional

Enrollment (Actual)

213

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Canada
    • Ontario
      • Toronto, Ontario, Canada
        • The Hospital for Sick Children

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

1 month to 1 year (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Acute bronchiolitis
  • Age 4 weeks to 12 months
  • Baseline Respiratory Disease Assessment Instrument (RDAI) ≥ 3 points
  • Informed consent
  • Availability of a telephone

Exclusion Criteria:

  • Pre-existing pulmonary or cardiac distress, neuromuscular disease, congenital or acquired airway anomalies, hemoglobinopathies, or chronic hypoxia
  • Severe respiratory distress, defined as the retraction component on the RDAI as 8 out of possible 9 points
  • True baseline oxygen saturation less than 88% in room air
  • Transfers from other institutions

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: 1
In this arm, patients are monitored with oximeters displaying true saturation values
Other: True saturation values displayed
Physicians will be presented with real saturations.
Experimental: 2
In this arm, patients are monitored with oximeters with displayed saturations 3 percentage points above true values
Other: Altered saturation values displayed.
Physicians will be presented with saturation measurements three percentage points above the true values.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Hospitalization for bronchiolitis
Time Frame: 72 hours from start of study
72 hours from start of study

Secondary Outcome Measures

Outcome Measure
Time Frame
The proportions of infants receiving supplemental oxygen in the ED
Time Frame: 72 hours from start the study
72 hours from start the study
Length of stay in the ED (from the time of arrival to the disposition decision)
Time Frame: Determined by outcome measure
Determined by outcome measure
Proportions of infants with unscheduled medical visits for bronchiolitis symptoms to any medical facility
Time Frame: 72 hours from start of study.
72 hours from start of study.
Proportion of the ED staff/fellows in "strong agreement" or "agreement" with discharge
Time Frame: 0, 60, 120, 180, 240, 300, and 360 minutes
0, 60, 120, 180, 240, 300, and 360 minutes

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

The Hospital for Sick Children

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

March 1, 2008

Primary Completion (Actual)

May 1, 2013

Study Completion (Actual)

May 1, 2013

Study Registration Dates

First Submitted

May 5, 2008

First Submitted That Met QC Criteria

May 5, 2008

First Posted (Estimate)

May 7, 2008

Study Record Updates

Last Update Posted (Estimate)

December 9, 2013

Last Update Submitted That Met QC Criteria

December 6, 2013

Last Verified

December 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 1000011675

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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