Safe, Effective and Cost-Effective Oxygen Saturation Targets for Children and Adolescents With Respiratory Distress: a Randomized Controlled Trial

Inclusion Criteria:

• 6 weeks to 12 years of age (corrected age for children with gestational age < 37weeks)

• hospitalized with respiratory distress due to bronchiolitis, viral wheeze or lowerrespiratory tract infection, as diagnosed by the treating physician. Viral wheezecan only be diagnosed below the age of 6 years.

• requiring supplemental oxygen as per usual care (SpO2 <92% or for treating symptomsof respiratory distress as determined by the treating physician

As respiratory distress in children with an asthma attack is mainly driven by hypoxia, they are at risk of undertreatment in the acute phase of the attack. Therefore, children aged 6-12 years of age with an asthma attack are excluded from this study.

Exclusion Criteria:

• children with, except for the studied diseases, pre-existing cardiopulmonary,neurological or hematological conditions (e.g. congenital thoracic malformation,airway malacia, post infectious bronchiolitis obliterans, childhood interstitiallung disease. primary immune deficiency)

• children born <32 weeks gestational age

• children already included in other studies, which potentially interfere with thisstudy

• children (of parents) without a stable internet connection needed for answeringquestionnaires

• children previously included in the current study

• considering questionnaires are only available in Dutch and English, children (ofparents) with different languages will be excluded.