The Bronchiolitis Infant Discharge Study published in the Lancet won the prestigious UK Clinical Paper of the year at the BMJ 2016 Awards.
Bronchiolitis is a common infection in infants and a minority require admission to hospital where oxygen levels are monitored and supplemental oxygen provided to those that fall below an oxygen saturation threshold. The question is where that threshold should lie?
Professor Steve Cunningham of the Dept Child Life and Health, University of Edinburgh and colleagues designed a trial a double-blind trial in which infants (younger than 12 months) were randomised to 90% or 94% oxygen saturation. They looked at outcomes (primary outcome was time to resolution of cough) and the impact on service. Those in the lower oxygen saturation required less time on oxygen supplementation thereby reducing hospital admission times.
BMJ Judges' comments: With this study, defining oxygen saturation targets in infants with bronchiolitis can finally move from opinion based to evidence based medicine. The study is elegantly designed and brings robust evidence to treatment decisions concerning one of the most common causes of hospital admission in infants."
BIDS was an exemplary example of networking with 8 hospitals in the UK participating. 615 babies admitted to hospital with bronchiolitis were randomised to the interventional study. Successful recruitment was possible due to the commitment of the study teams involved and the sharing of best practice between study sites. BIDS closed on time and recruited to target. BIDs was HTA funded.
One of the main challenges was recruting babies during the night when staff resources were tight and parents were anxious. Suitable recruitment strategies were identified and tailored for each Children’s Hospital admissions process. ScotCRN and NIHR- CRN research nurses championed the study, maintaining regular contact with staff, keeping a high profile in the hospital and ensuring that GCP training was rolled out to appropriate staff.
The paper can be read on the Lancet website.
Author: P Dicks