Abstract
ObjectivesThis study examines the practice patterns with respect to the technique of non-oral hydration of infants admitted with bronchiolitis at one Canadian tertiary care institution. Additionally, the authors assess the infants’ parents’ attitudes regarding hydration through a nasogastric (NG) tube instead of an intravenous (IV) line.MethodsA retrospective chart review was conducted for all infants admitted with bronchiolitis from May 1, 2016, to April 30, 2018, with a focus on the method of hydration, investigation with chest radiography, and use of IV antibiotics. Parents of infants who received IV fluids during the admission were surveyed by mail to assess their perceptions surrounding their child's experience with IV fluid therapy as well as their attitudes toward NG hydration, particularly in cases of difficult IV access.ResultsOf the 101 hospitalized infants, 54 received IV fluids and four received NG fluids. Of the 54 eligible for the survey, 17 completed surveys were returned. Parents were likely to consider NG hydration if suggested by their pediatrician. The proportion was extremely or very likely to consider this intervention increased from 29% in a generic situation to 53% in a scenario where there was more than one unsuccessful IV attempt (p=0.03).ConclusionsIn the institution studied, NG hydration was rarely used. Parents seemed receptive to the idea of NG hydration as an alternative, particularly when IV access is difficult.
Highlights
Bronchiolitis is a common acute respiratory illness affecting infants and children less than two years of age [1,2,3]
This study examines the practice patterns with respect to the technique of non-oral hydration of infants admitted with bronchiolitis at one Canadian tertiary care institution
The proportion was extremely or very likely to consider this intervention increased from 29% in a generic situation to 53% in a scenario where there was more than one unsuccessful IV attempt (p=0.03)
Summary
Bronchiolitis is a common acute respiratory illness affecting infants and children less than two years of age [1,2,3]. The illness is mild; hospitalization may be necessary in cases of severe respiratory distress, inability to maintain oxygenation and ventilation, or inadequate oral fluid intake [4,5]. If oral intake is ineffective or unadvisable, supplementary fluids can be administered either through an intravenous (IV) line or via a nasogastric (NG) tube (or, in some cases, an orogastric tube) [6,7]. Clinical trials have suggested that outcomes are similar for IV and NG hydration [8,9]. Practice patterns vary greatly when it comes to the method of hydration, with North American settings typically choosing the IV route [2], while other settings, such as Australia and New Zealand, commonly utilize the NG route, and variation in practice may be determined more by medical culture than evidence or parental preference [14]
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