Acute bronchiolitis management is centred on supportive care, with clear guidance on when and how supplemental oxygen should be introduced based on oxyhemoglobin saturation monitoring.
The primary goal is to maintain oxyhemoglobin saturation above 90%.
The protocol specifies a saturation threshold that triggers supplemental oxygen use, along with a preferred delivery method for infants who do not require additional respiratory support.
DOI: 10.1542/peds.2014-2742
Clinicians may choose not to administer supplemental oxygen if the oxyhemoglobin saturation exceeds 90% in infants and children with a diagnosis of bronchiolitis (Evidence Quality: D; Recommendation Strength: Weak Recommendation [based on low level evidence and reasoning from first principles]).
Supplemental oxygen provided for infants not requiring additional respiratory support is best initiated with nasal prongs, although exact measurement of fraction of inspired oxygen is unreliable with this method.
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