Can children with infectious conditions requiring oxygen therapy be discharged at a SpO2 of 88%?

An oxygen saturation level of 88% may be adequate for hospital discharge, compared to the conventional threshold of 92%, in children with various infectious respiratory conditions that require oxygen supplementation.

OxyKids (NCT06016244) was a randomised, controlled trial assessing SpO2 thresholds of 88% versus 92% for starting and stopping oxygen supplementation. Study participants included children aged 6 weeks to <12 years with bronchiolitis, viral wheezing, or other lower respiratory tract infections requiring oxygen therapy. The primary outcome was time to hospital discharge readiness. A total of 560 children were enrolled in the study.

Dr Sam Louman (Spaarne Gasthuis Academy, the Netherlands) presented the results. The median time-to-discharge readiness was 27.6h (IQR 15.2-52.4) in the SpO2 88% group and 46.6h (IQR 24.3-85.1) in the SpO2 92% group, corresponding to a reduction of a third in discharge time (P<0.001) [1]. These differences between groups were maintained in subgroup analyses by age (1-4 and 4-12 years) and condition (bronchiolitis, viral wheeze, or lower respiratory tract infection). However, any-cause general practitioner visits within 28 days after discharge tended to be higher in the SpO2 88% group versus the 92% group (19.1% vs 11.8%; rate ratio 1.56; 95%CI 1.01-2.41; P=0.046).

“OxyKids showed that the 88% threshold is safe and should be adopted over the 92% threshold”, concluded Dr Louman. “Some patients might need an extra general practitioner visit, but this is outweighed by the substantial reduction in time-to-discharge readiness, avoidance of unnecessary oxygen administration, and the opportunity for children to recover safely at home .”

1. Louman S, et al. Conservative versus standard oxygen saturation thresholds in children with acute respiratory distress: a multicentre randomised controlled trial (OxyKids). ERS Congress, 27 September–1 October 2025, Amsterdam, the Netherlands.

Medical writing support was provided by Mihai Surducan, PhD.

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Posted on 1 October 20253 November 2025