Bronchiolitis Follow Up

Monitoring

Patient Monitoring  

Cardiac and respiratory rate monitoring during the acute stage of the disease must be considered, when the risk of apnea and/or bradycardia is greatest. Once pulse and respiratory rate have been stabilized, monitoring may be discontinued. Hourly SaO₂ monitoring is recommended for patients with moderate bronchiolitis. Patients <1 month old with history of apneic episodes and prematurity should be monitored for apnea. Continuous cardiorespiratory and SaO₂ monitoring is recommended for patients with severe bronchiolitis. Spot pulse oximetry checks are preferred for patients showing clinical improvement. Continuous pulse oximetry monitoring may be considered in patients showing severe symptoms of bronchiolitis upon admission. Mechanical monitoring devices for heart rate, respiratory rate, and SaO₂ must be utilized discriminately, so that their use will not result in failure to discharge the patient from the hospital in a timely manner.  

Suctioning  

Secretions should be suctioned regularly, before feeding, prior to each inhalational therapy, with the presence of signs of upper airway obstruction, or as needed. It should be performed before measuring O₂ saturation in infants to avoid over-diagnosis of hypoxemia.

Discharge Criteria

• Autonomy from any respiratory support with O₂ saturation ≥93% in room air
• Clinically stable
• Adequate oral feeding and intake of fluids (75% of usual volume)
• Family unit able to monitor and administer therapy at home
• Local availability of pediatric health care