In bronchiolitis with hypoxemia, what SpO2 target is generally recommended?

• A. SpO2 ≥95%.
• B. SpO2 ≥92%.
• C. SpO2 ≥90%.
• D. SpO2 ≥98%.

Answer: (B)

In bronchiolitis with hypoxemia, the aim of oxygen therapy is to keep tissues adequately oxygenated without pushing oxygen use to unnecessarily high levels. A practical target of SpO2 around 92% provides a safe margin above the threshold for hypoxemia while avoiding the potential downsides of higher oxygen concentrations.

Healthy infants usually run SpO2 well into the mid-90s to 100%, but bronchiolitis involves airway inflammation and V/Q mismatch. Targeting about 92% ensures enough oxygen delivery to meet needs without automatically driving FiO2 higher to reach 95–100%, which isn’t shown to improve outcomes and can increase risk of oxygen toxicity or atelectasis.

Higher targets (like 95% or 98%) would mean more oxygen administration than necessary in many cases, whereas lowering to 90% could risk under-oxygenation for a child who already has impaired gas exchange. Thus, the commonly recommended target in this setting is SpO2 ≥92%.