Abstract
SESSION TITLE: Tuesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM PURPOSE: The use of HFNC as non- invasive respiratory support in children with bronchiolitis has increased over the last several years. Several studies have investigated enteral feeding safety while on HFNC. This study investigates the safety of oral feeding prior to and following implementation of a HFNC feeding protocol. The purpose is to 1) Investigate safety of feeding in children with bronchiolitis on HFNC, 2) timing of enteral feeding initiation and quantify the HFNC flow for safe feeding. METHODS: A retrospective observational cohort study in children ≤2 years of age with bronchiolitis, requiring HFNC, from September, 2017 to January 15, 2019. Feeding complications were defined as increased work of breathing within one hour at start of feeding, vomiting, increased HFNC settings. Safety of enteral feeding was defined as absence of feeding complications. We recorded the timing of enteral feeding from the initiation of HFNC, duration of enteral feeding while on HFNC, and the flow of HFNC at which the feeding was initiated. We compare the data prior and post implementation of a HFNC feeding protocol. RESULTS: Descriptive statistics were calculated separately by pre and post protocol implementation. Comparison of two groups using the chi-square test for categorical variables and Mann-Whitney for continuous data and statistical significance at p<0.05 level. Analyses were performed using SAS version 9.4 (SAS Institute Inc. Cary, NC). Patients in both, pre- and post-protocol implementation groups have no feeding complications on HFNC. Subjects in Post (n=30) vs. Pre-Protocol Implementation (n=36) had a higher median amount of liters flow when initiating enteral feeding (8.0 vs. 6.0 respectively, p<0.024) and prolonged days on HFNC (4.0 vs. 3.0, p<0.030). Post-protocol implementation, enteral feeding was initiated sooner (days NPO 1.0 vs 2.0). No other significant differences between the two cohorts with respect to other variables were observed. (Table 1). CONCLUSIONS: Our data supports that enteral feeding in patients with bronchiolitis on HFNC is safe. Standardization due to current protocol, allowed safe earlier feeding of children on HFNC, reducing the time spent NPO. CLINICAL IMPLICATIONS: The use of HFNC offers an innovative alternative to traditional oxygen delivery and allows safe enteral feeding under the current bronchiolitis protocol at our institution. DISCLOSURES: No relevant relationships by Meredith Akerman, source=Web Response No relevant relationships by Arsenia Asuncion, source=Web Response No relevant relationships by Thomas Conway, source=Web Response My spouse/partner as a Employee relationship with Siement Healthiniers Please note: >$100000 Added 03/15/2019 by Claudia Halaby, source=Web Response, value=Salary
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