***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES . Although bronchiolitis is the leading cause of hospitalization for infants , there are limited data describing the epidemiology of bronchiolitis hospitalizations , and the associated cost is unknown . Our objective was to determine nationally representative estimates of the frequency of bronchiolitis hospitalizations and its associated costs . PATIENTS AND METHODS . We analyzed the 2002 Health Care Utilization Project-National Inpatient Sample , a federal , stratified r and om survey of hospital discharges . For admissions age < 2 years with a discharge diagnosis of bronchiolitis ( International Classification of Diseases , Ninth Revision , Clinical Modification , code 466.1 ) , we used nationally representative weighted estimates to determine frequency and total hospital charges . Costs were estimated from reported charges by applying hospital-specific cost/charge ratios based on all-payer inpatient cost . RESULTS . In 2002 , an estimated 149000 patients were hospitalized with bronchiolitis .  Frequency of hospitalizations was higher among children age < 1 year of age , male gender , and nonwhite race .  Mean length of stay was 3.3 days . Total annual costs for bronchiolitis-related hospitalizations were $ 543 million , with a mean cost of $ 3799 per hospitalization . Mean cost of bronchiolitis with a codiagnosis of pneumonia was $ 6191 . In a multivariate analysis controlling for 3 confounding factors ( including length of stay ) , cost per hospitalization was higher for children ≥1 year and lower for those in the South versus Northeast . CONCLUSIONS . Bronchiolitis admissions cost more than $ 500 million annually . A codiagnosis of bronchiolitis and pneumonia almost doubles the cost of the hospitalization . Inpatient health care costs of bronchiolitis are higher than estimated previously and highlight the need for initiatives to safely reduce bronchiolitis hospitalizations and thereby decrease health care costs OBJECTIVE High incidence , rising admission rates , and relatively ineffective therapies make the management of bronchiolitis controversial . Since 1980 , the rate of hospitalization for children with bronchiolitis has increased by nearly 250 % , whereas mortality rates for the disease have remained constant . It has been speculated that the increasing use of pulse oximetry has lowered the threshold for admission and may have contributed to the rise in bronchiolitis-related admissions . The objective of this study was to describe pediatric emergency medicine physicians ' management preferences regarding infants with moderately severe bronchiolitis and to assess the influence of specific differences in oxygen saturation as measured by  pulse oximetry ( SpO2 ) and respiratory rate ( RR ) on the decision to admit . METHODS Physicians who are members of the American Academy of Pediatrics Section of Emergency Medicine and living in the United States were r and omized into 4 groups and mailed a survey that contained 1 of 4 vignettes . Vignettes were identical except for given SpO2 values ( 94 % or 92 % ) and RR ( 50/min or 65/min ) . Subjects were asked to answer questions regarding laboratory tests , treatment options , and the decision to admit for the patient in their vignette . RESULTS We received completed surveys from 519 ( 64 % ) of the 812 physicians contacted . Most respondents recommended use of bronchodilators ( 96 % ) , nasal suction ( 82 % ) , and supplemental oxygen ( 57 % ) . Few respondents recommended decongestants ( 9 % ) , steroids ( 8 % ) , or antibiotics ( 2 % ) . When asked to rank therapies , respondents gave nasal suction 182 number 1 votes ; bronchodilators received 164 . The decision to admit varied with SpO2 and RR . Forty-three percent of respondents who received a vignette featuring SpO2 of 94 % and a RR of 50/min recommended admission for the infant in their vignette . Fifty-eight percent recommended admission when the vignette SpO2 was 94 % and RR was 65/min ( chi2 = 5.021 ) . Respondents who received a vignette with SpO2 of 92 % were nearly twice as likely to recommend admission : 83 % recommended admission when vignette RR was 50/min , and 85 % recommended admission when vignette RR was 65/min ( chi2 = 0.126 ) . CONCLUSIONS When treating infants with moderately severe bronchiolitis , pediatricians who work in emergency departments frequently use bronchodilators and nasal suction , 2 practice s for which supporting data are either conflicting ( bronchodilators ) or nonexistent ( nasal suction ) . In addition , their decisions to admit differ markedly on the basis of only a 2 % difference in SpO2 . It is possible that increased reliance on pulse oximetry has contributed to the increase in bronchiolitis hospitalization rates seen during the past 2 decades 
    Output:
    
REVIEW ER 'S CONCLUSIONS There is insufficient evidence to support the use of epinephrine for the treatment of bronchiolitis among in patients .
There is some evidence to suggest that epinephrine may be favourable to salbutamol and placebo among out patients .