Automated oxygen kept bronchiolitis infants in range more of the time but did not shorten stay

Design

Multicentre randomised controlled trial

Population

103 infants aged 1–12 months with non-severe bronchiolitis needing oxygen

Primary outcome

Length of hospital stay

Effect

Median 71.0 vs 69.6 hours (P = 0.39); time in target 89.4% vs 74.9%

A French multicentre trial randomised 103 infants aged 1–12 months admitted with non-severe bronchiolitis and saturations below 92% to automated closed-loop oxygen titration or standard manual adjustment.

Median length of stay was similar, 71 versus 70 hours (P = 0.39). Infants on the automated system spent more time in the target saturation range (89% vs 75%) and needed lower oxygen flow (median 0.1 vs 0.3 L/min). Readmission and non-invasive ventilation use did not differ.

The trial recruited fewer infants than planned, so it may have missed a modest effect on stay. For now the main gain is tighter oxygen control with less oxygen used — useful where oxygen supply is limited, but not yet a reason to buy devices to shorten admissions.

• Automated oxygen titration did not shorten bronchiolitis admissions in this trial
• It kept saturations in target range more of the time and used less oxygen
• The trial was under-recruited, so a modest benefit on stay cannot be excluded
• Careful manual titration to a saturation target remains standard

Why it matters

Better saturation control has not yet translated into the outcome families and wards care about.

The statistics, in plain English

A P value of 0.39 for length of stay means no detectable difference, but with only 103 infants the trial had limited power to find a small one.

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