Background: Hypoxia associated with bronchiolitis is not always easy to assess on clinical grounds alone. The aim\r\nof this study was to determine the value of food intake during the previous 24 hours (bottle and spoon feeding), as\r\na percentage of usual intake (24h FI), as a marker of hypoxia, and to compare its diagnostic value with that of usual\r\nclinical signs.\r\nMethods: In this observational, prospective, multicenter study, 18 community pediatricians, enrolled 171 infants,\r\naged from 0 to 6 months, with bronchiolitis (rhinorrhea + dyspnea + cough + expiratory sounds). Infants with risk\r\nfactors (history of prematurity, chronic heart or lung disorders), breast-fed infants, and infants having previously\r\nbeen treated for bronchial disorders were excluded.\r\nThe 24h FI, subcostal, intercostal, supracostal retractions, nasal flaring, respiratory rate, pauses, cyanosis, rectal\r\ntemperature and respiratory syncytial virus test results were noted. The highest stable value of transcutaneous\r\noxygen saturation (SpO2) was recorded. Hypoxia was noted if SpO2 was below 95% and verified.\r\nResults: 24h FI = 50% was associated with a 96% likelihood of SpO2 = 95% [95% CI, 91ââ?¬â??99]. In univariate analysis,\r\n24h FI < 50% had the highest odds ratio (13.8) for SpO2 < 95%, compared to other 24h FI values and other clinical\r\nsigns, as well as providing one of the best compromises between specificity (90%) and sensitivity (60%) for\r\nidentifying infants with hypoxia. In multivariate analysis with adjustment for age, SpO2 < 95% was related to the\r\npresence of intercostal retractions (OR = 9.1 [95% CI, 2.4-33.8%]) and 24h FI < 50% (OR = 10.9 [95% CI, 3.0-39.1%]).\r\nHospitalization (17 infants) was strongly related to younger age, 24h FI and intercostal retractions.\r\nConclusion: In practice, the measure of 24 h FI may be useful in identifying hypoxia and deserves further study.
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