Food intake during the previous 24 h as a percentage of usual intake: a marker of hypoxia in infants with bronchiolitis: an observational, prospective, multicenter study

In this observational, prospective, multicenter study, 18 community pediatricians, enrolled 171 infants, aged from 0 to 6 months, with bronchiolitis (rhinorrhea？+？dyspnea？+？cough？+？expiratory sounds). Infants with risk factors (history of prematurity, chronic heart or lung disorders), breast-fed infants, and infants having previously been treated for bronchial disorders were excluded.The 24h FI, subcostal, intercostal, supracostal retractions, nasal flaring, respiratory rate, pauses, cyanosis, rectal temperature and respiratory syncytial virus test results were noted. The highest stable value of transcutaneous oxygen saturation (SpO2) was recorded. Hypoxia was noted if SpO2 was below 95% and verified.24h FI？≥？50% was associated with a 96% likelihood of SpO2？≥？95% [95% CI, 91–99]. In univariate analysis, 24h FI？<？50% had the highest odds ratio (13.8) for SpO2？<？95%, compared to other 24h FI values and other clinical signs, as well as providing one of the best compromises between specificity (90%) and sensitivity (60%) for identifying infants with hypoxia. In multivariate analysis with adjustment for age, SpO2？<？95% was related to the presence 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%]). Hospitalization (17 infants) was strongly related to younger age, 24h FI and intercostal retractions.In practice, the measure of 24 h FI may be useful in identifying hypoxia and deserves further study.Bronchiolitis is the most common viral infection of the lower respiratory tract in infants under 1 year of age [1]. It affects more than 400 000 infants every year in France [2] and is responsible for tens of thousands of hospital admissions. Respiratory syncytial virus (RSV) is usually responsible for the first episode, but other viruses may also be involved. Bronchiolitis is usually mild, resolving spontaneously within a few days, but some infants, especially the very young, develop severe forms with hypoxia and may need ho