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Enteral hydration in high-flow therapy for infants with bronchiolitis: Secondary analysis of a randomised trial

Franz E Babl1,2,3,4, Donna Franklin1,5,6,7,8,9, Luregn J Schlapbach5,7,8,9

  • 1Paediatric Research in Emergency Departments International Collaborative (PREDICT), Melbourne, Victoria, Australia.

Journal of Paediatrics and Child Health
|February 12, 2020
PubMed

Insights

Enteral hydration is safe for infants receiving high-flow oxygen therapy for bronchiolitis. This study found no pulmonary aspiration events in infants hydrated orally or via nasogastric tube while on high-flow oxygen.

Area of Science:

  • Pediatric critical care
  • Respiratory medicine
  • Neonatology

Background:

  • Nasal high-flow oxygen therapy is a common supportive treatment for infants with bronchiolitis.
  • The safety of enteral hydration in infants receiving high-flow oxygen therapy is not well-established.

Purpose of the Study:

  • To assess the safety of enteral hydration in infants with bronchiolitis receiving high-flow oxygen therapy.
  • To evaluate adverse events associated with different hydration methods in this population.

Main Methods:

  • A secondary analysis of a multi-center randomized controlled trial involving infants under 12 months with bronchiolitis and oxygen requirements.
  • Infants were assigned to high-flow or standard oxygen therapy.
  • Adverse events were assessed based on hydration methods: intravenous (IV), nasogastric tube (NGT) bolus/continuous, or oral.

Main Results:

  • Of 505 infants on high-flow, 71.3% received only enteral fluids, and 18.4% received both IV and enteral fluids.
  • Among enterally hydrated infants, methods included NGT bolus, continuous NGT, oral hydration, or combinations.
  • No pulmonary aspiration events occurred in infants hydrated orally or via NGT (0%); one patient experienced pneumothorax (0.2%).

Conclusions:

  • Enteral hydration is safe for the majority of infants with hypoxic respiratory failure due to bronchiolitis.
  • Hydration via oral or nasogastric routes can be safely administered during high-flow oxygen therapy.
Abstract

Keywords:
bronchiolitisenteral hydrationhigh-flow

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