title: Nasogastric Hydration in Infants with Bronchiolitis Less Than 2 Months of Age.
abstract: OBJECTIVE
  To determine whether nasogastric hydration can be used in infants less than 2 months of age with bronchiolitis, and characterize the adverse events profile of these infants compared with infants given intravenous (IV) fluid hydration.
  
  
  METHODS
  A descriptive retrospective cohort study of children with bronchiolitis under 2 months of age admitted for hydration at 3 centers over 3 bronchiolitis seasons was done. We determined type of hydration (nasogastric vs IV fluid hydration) and adverse events, intensive care unit admission, and respiratory support.
  
  
  RESULTS
  Of 491 infants under 2 months of age admitted with bronchiolitis, 211 (43%) received nonoral hydration: 146 (69%) via nasogastric hydration and 65 (31%) via IV fluid hydration. Adverse events occurred in 27.4% (nasogastric hydration) and 23.1% (IV fluid hydration), difference of 4.3%; 95%CI (-8.2 to 16.9), P = .51. The majority of adverse events were desaturations (21.9% nasogastric hydration vs 21.5% IV fluid hydration, difference 0.4%; [-11.7 to 12.4], P = .95). There were no pulmonary aspirations in either group. Apneas and bradycardias were similar in each group. IV fluid hydration use was positively associated with intensive care unit admission (38.5% IV fluid hydration vs 19.9% nasogastric hydration; difference 18.6%, [5.1-32.1], P = .004); and use of ventilation support (27.7% IV fluid hydration vs 15.1% nasogastric hydration; difference 12.6 [0.3-23], P = .03). Fewer infants changed from nasogastric hydration to IV fluid hydration than from IV fluid hydration to nasogastric hydration (12.3% vs 47.7%; difference -35.4% [-49 to -22], P < .001).
  
  
  CONCLUSIONS
  Nasogastric hydration can be used in the majority of young infants admitted with bronchiolitis. Nasogastric hydration and IV fluid hydration had similar rates of complications.
authors: Department of Emergency Medicine, Royal Children's Hospital Victoria, Parkville, Victoria, Australia. Electronic address: ed.oakley@rch.org.au.
authors: Ed
authors: E
authors: Oakley
authors: Department of Emergency Medicine, Royal Children's Hospital Victoria, Parkville, Victoria, Australia.
authors: Sonny
authors: S
authors: Bata
authors: Department of Emergency Medicine, Royal Children's Hospital Victoria, Parkville, Victoria, Australia.
authors: Sharmila
authors: S
authors: Rengasamy
authors: Department of Emergency Medicine and Pediatrics, Sunshine Hospital, St Albans, Victoria, Australia.
authors: David
authors: D
authors: Krieser
authors: Department of Emergency Medicine, Monash Medical Centre, Clayton, Victoria, Australia.
authors: John
authors: J
authors: Cheek
authors: Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
authors: Kim
authors: K
authors: Jachno
authors: Department of Emergency Medicine, Royal Children's Hospital Victoria, Parkville, Victoria, Australia.
authors: Franz E
authors: FE
authors: Babl
mesh_terms: D001315:Australia; D001988:Bronchiolitis / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D015278:Intensive Care Units, Pediatric; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies
keywords: bronchiolitis; hydration; respiratory syncytial virus