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Method of Hydration for Infants Admitted With Bronchiolitis: Physician or Parental Choice?
Saima Saqib1, Gerald Mugford2, Kevin Chan3
1Faculty of Medicine, Memorial University of Newfoundland, St. John's, CAN.
Insights
Nasogastric (NG) hydration is rarely used for infants with bronchiolitis, but parents are open to it, especially when intravenous (IV) access is challenging. This study explored hydration practices and parental attitudes towards NG feeding as an alternative to IV fluids.
Area of Science:
- Pediatrics
- Neonatology
- Respiratory Medicine
Background:
- Bronchiolisi is a common respiratory infection in infants.
- Non-oral hydration is crucial for managing severe cases.
- Nasogastric (NG) and intravenous (IV) routes are common hydration methods.
Purpose of the Study:
- To examine hydration practice patterns in infants with bronchiolitis.
- To assess parental attitudes towards NG hydration versus IV hydration.
- To evaluate the use of NG hydration as an alternative to IV fluids.
Main Methods:
- Retrospective chart review of infants admitted with bronchiolitis.
- Survey of parents regarding their perceptions of IV and NG hydration.
- Analysis of hydration methods, chest radiography, and IV antibiotic use.
Main Results:
- NG hydration was rarely used in the studied institution (4 out of 101 infants).
- Parental likelihood to consider NG hydration increased significantly when IV access was difficult (29% to 53%).
- Parental acceptance of NG hydration was higher when recommended by a pediatrician.
Conclusions:
- NG hydration is underutilized for infants with bronchiolitis.
- Parents show a positive attitude towards NG hydration, particularly in challenging IV access scenarios.
- Pediatrician recommendation is a key factor in parental acceptance of NG hydration.
Abstract:
Objectives 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. Additionally, the authors assess the infants' parents' attitudes regarding hydration through a nasogastric (NG) tube instead of an intravenous (IV) line. Methods A 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. Results Of 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). Conclusions In 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.
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