What is the best treatment for a 6-month-old with bronchiolitis and an SpO₂ of 89%?

Providing high-flow nasal cannula (NC) humidified oxygen is the most appropriate treatment for a 6-month-old with bronchiolitis and an oxygen saturation (SpO₂) of 89%. In infants, bronchiolitis is often caused by a viral infection, most commonly respiratory syncytial virus (RSV), and is characterized by inflammation of the small airways. When there is significant respiratory distress or low oxygen saturation, the primary goal of treatment is to ensure adequate oxygenation.

Humidified oxygen helps to maintain moisture in the airways, which can aid in reducing respiratory distress by thinning secretions and facilitating easier breathing. In cases where the SpO₂ drops below 90%, providing supplemental oxygen is critical to prevent complications such as hypoxia, especially in young children.

While other options such as administering racemic epinephrine, using albuterol, or initiating steroids may have roles in the management of bronchospasm or inflammation in certain contexts, they are not the first-line treatments for bronchiolitis in infants. Specifically, bronchodilators, such as albuterol, have not consistently been shown to provide significant benefit in improving clinical outcomes for bronchiolitis in this age group. Similarly, steroids are not