Society of Hospital Medicine – Pediatric Hospital Medicine

View all recommendations from this society

Released February 21, 2013

Don’t use continuous pulse oximetry routinely in children with acute respiratory illness unless they are on supplemental oxygen.

The utility of continuous pulse oximetry in pediatric patients with acute respiratory illness is not well established. Use of continuous pulse oximetry has been previously associated with increased admission rates and increased length of stay. The clinical benefit of pulse oximetry is not validated or well documented.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

A Delphi panel of pediatric hospital medicine physicians with wide geographic representation was convened by the Society of Hospital Medicine (SHM). The panel developed an initial list of 20 items with input from colleagues at each of the panelists’ home institutions, which was then discussed and reduced to 11 items via consensus of the panel. A comprehensive literature review was undertaken for these 11 items, while they were concurrently circulated on the electronic listservs of SHM’s Pediatric Committee and the American Academy of Pediatrics’ Section on Hospital Medicine. The collated comments along with the results of the evidence review were then presented to the members of the panel.

Two rounds of Delphi voting took place via electronic submission of votes by the panel. Validity and feasibility of each item was assessed by the Delphi panel on a nine-point scale for each of the 11 items and the mean of each item was obtained. The aggregate score of the means of validity and feasibility decided the final five items. These recommendations were then submitted to the SHM Board for review and approval.

SHM’s disclosure and conflict of interest policy can be found at


American Academy of Pediatrics. Diagnosis and Management of Bronchiolitis, Subcommittee on Diagnosis and Management of Bronchiolitis. Pediatrics. 2006 Oct;118(4):1774-93.

Schroeder AR, Marmor AK, Pantell RH, Newman TB. Impact of pulse oximetry and oxygen therapy on length of stay in bronchiolitis hospitalizations. Arch Ped Adolesc Med. 2004 Jun;158(6):527-530.

Hunt CE, Corwin MJ, Lister G, Weese-Mayer DE, Neuman MR, Tinsley L, Baird TM, Keens TG, Cabral HJ. Longitudinal assessment of hemoglobin oxygen saturation in healthy infants during the first 6 months of age. J Pediatr. 1999 Nov;135(5):580-6.

Alverson BK, McCulloh RJ, Koehn KL. Continuous versus intermittent pulse oximetry monitoring of children hospitalized for bronchiolitis. Abstract presented at IDWeek 2012. Sand Diego (CA). 2012 Oct 19.