Related Experiment Video
Updated: Jul 17, 2026
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Enteral feeding in pediatric patients with bronchiolitis requiring non-invasive support via nasal interface
Kelsey Finnegan1, Julia Smalley1, Barbara Gallagher1
1Division of Pediatric Critical Care Medicine, MassGeneral Brigham for Children, Boston, MA, USA.
Insights
Oral feeding in children with bronchiolitis on non-invasive respiratory support is safe and reduces pneumonia risk and hospital stay. Nasogastric feeding increased pneumonia odds.
Area of Science:
- Pediatric critical care medicine
- Pediatric pulmonology
- Neonatal and infant nutrition
Background:
- Enteral feeding is crucial for critically ill children.
- Non-invasive respiratory support may delay feeding due to safety concerns.
- Bronchiolitis is a common respiratory illness in infants.
Purpose of the Study:
- To investigate the safety of oral versus nasogastric feeding in children with bronchiolitis on non-invasive respiratory support.
- To determine the association between feeding method and adverse events, including pneumonia and respiratory support escalation.
- To evaluate the impact of feeding method on length of stay.
Main Methods:
- Retrospective cohort study of 407 patients aged 0-24 months with bronchiolitis.
- Patients received non-invasive respiratory support via nasal interfaces.
- Comparative statistics and multivariable regression analyzed feeding method (oral vs. nasogastric) and clinical outcomes.
Main Results:
- Nasogastric feeding was associated with a 4.65-fold increased odds of developing new pneumonia compared to oral feeding.
- No significant differences in pneumonia development, respiratory support escalation, or highest support level were found based on feeding method.
- Oral feeding was linked to decreased pediatric intensive care unit and overall hospital lengths of stay.
Conclusions:
- Enteral feeding via mouth or orogastric tube is safe for children with bronchiolitis on non-invasive respiratory support.
- Oral feeding is associated with a reduced risk of pneumonia and shorter hospital stays.
- Further research is needed to assess long-term safety and nutritional adequacy of oral feeding in this population.
Background And Objectives:
The benefits of enteral feeding in critically ill children have been well described, but the use of non-invasive respiratory support has been shown to delay initiation of feeds, in part due to safety concerns. We aimed to examine the association of enteral feeding by mouth and orogastric tube on clinically significant adverse events in children with bronchiolitis being treated with non-invasive respiratory support via nasal interfaces.
Methods:
A retrospective cohort study of patients 0-24 months of age between 2016 and 2022 in a quaternary care hospital pediatric intensive care unit with a diagnosis of bronchiolitis and treatment with non-invasive respiratory support via nasal interface. Standard comparative statistics and multivariable regression were used to determine the association between oral and nasogastric feeding and clinically significant outcomes such as new diagnosis of pneumonia and escalation in respiratory support, as well lengths of stay.
Results:
There were 407 patients 24 months or younger who were admitted with bronchiolitis and treated with non-invasive respiratory support. There was a 4.65 increased odds of developing a new pneumonia for patients who were fed nasogastrically versus orally. There were no differences in the development of pneumonia based on type of respiratory support, whether an escalation in respiratory support was needed, or based on the highest level of support received. Both pediatric intensive care unit and overall hospital lengths of stay were decreased in those who were orally fed.
Conclusions:
Enteral feeding in children with bronchiolitis receiving non-invasive respiratory support appears to be safe and not associated with escalation in support or new diagnoses of pneumonia. Oral feeds were associated with decreased lengths of stay. Further work is needed to assess long term safety and ability to achieve adequate nutritional requirements.
Impact:
Enteral feeding of children with bronchiolitis requiring non-invasive respiratory support via nasal interfaces did not have an effect on clinically significant adverse events Feeding by mouth led to decreased risk of pneumonia and shorter inpatient length of stay Future work is needed to study the ability to achieve nutrition goals when feeding by mouth on non-invasive support.
Related Concept Videos
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:15Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
01:17Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation (NIPPV)
01:26Enteral Nutrition I: Orogastric and Nasogastric Feeding
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...