Nutritional management of young infants presenting with acute bronchiolitis in Belgium, France and Switzerland: survey of current practices and documentary search of national guidelines worldwide

Valla, Frédéric V.; Baudin, Florent; Demaret, Pierre; Rooze, Shancy; Moullet, Clémence; Cotting, Jacques; Ford-Chessel, Carole; Pouyau, Robin; Peretti, Noël; Tume, Lyvonne N.; Milési, Christophe; Roux, Bénédicte Gaillard Le

doi:10.1007/s00431-018-3300-1

Cited by 17 publications

(11 citation statements)

References 34 publications

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“…Sochet et al reported that oral nutrition in infants with bronchiolitis was well tolerated and that the nasogastric tube was required for infants with higher RR 17 , and other studies have shown the difficulty with feeding and changes in swallowing that can occur among infants with bronchiolitis, showing that interference of respiratory discomfort can affect the efficacy of suction and the swallowing process 23,24 . Therefore, the need for a nasogastric tube may be a marker of the severity of respiratory distress.…”

Section: Discussionmentioning

confidence: 99%

Nasogastric tube, a warning sign for high-flow nasal cannula failure in infants with bronchiolitis

Nascimento

Quinto

Oliveira

et al. 2020

Sci Rep

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High-flow nasal cannula (HFNC) therapy is routinely used in the treatment of infants with bronchiolitis. This study sought to identify markers associated with failure of HFNC therapy that serve as warnings for early staging of other ventilatory support products. A retrospective study of infants with a diagnosis of bronchiolitis, receiving HFNC and admitted to the pediatric intensive care unit from January 2016 to June 2017, was conducted. The subjects were divided into two study groups according to the success or failure of HFNC therapy. Risk factors were assessed using the following variables: age, time between hospital admission and start of HFNC, equipment model, and the need for a nasogastric tube. Eighty-one infants were studied, and 18 (21.7%) of them exhibited therapy failure. The results of the logistic models showed that the chances of failure for patients requiring a nasogastric tube during HFNC use were more likely than those for patients with oral nutrition (OR = 8.17; 95% CI 2.30–28.99; p = 0.001). The HFNC failure was not associated with the device used (OR = 1.56; 95% CI 0.54–4.52; p = 0.41), time between hospital admission and HFNC installation (OR = 1.01; 95% CI 0.98–1.03; p = 0.73), or age (OR = 0.98; 95% CI 0.82–1.17; p = 0.82). Among late outcomes evaluated, the patients with therapy failure had longer total durations of O2 use (p < 0.001) and longer hospital stays (p < 0.001). The need to use a nasogastric tube during HFNC use was associated with HFNC therapy failure and can be considered as a marker of severity in children with bronchiolitis.

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Section: Discussionmentioning

confidence: 99%

Nasogastric tube, a warning sign for high-flow nasal cannula failure in infants with bronchiolitis

Nascimento

Quinto

Oliveira

et al. 2020

Sci Rep

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“…Many early guidelines recommended avoiding or limiting enteral nutrition in respiratory distress (American Bronchiolitis Guidelines), however NIV is no longer a barrier to enteral feeding, in accordance with recent updated guidelines (22).…”

Section: Discussionmentioning

confidence: 90%

Barriers to Delivery of Enteral Nutrition in Pediatric Intensive Care: A World Survey

Tume

Eveleens

Verbruggen

et al. 2020

Pediatric Critical Care Medicine

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This is the largest survey that has explored perceived barriers to the delivery of enteral nutrition across the world by physicians, nurses and dietitians. There were some similarities with adult intensive care barriers. In all professional groups, the perception of barriers reduced with years PICU experience. This survey highlights implications for PICU practice around more focussed nutrition education for all PICU professional groups.

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“…Although these events are rare, 23,24 disparate practices exist both regionally and by provider, including timing, route, and type of EN. 25,26 For children, a state of bad temperament or irritability from hunger, sometimes referred to as "hanger," 27 may anecdotally mimic respiratory distress or generate alarming vital signs that prolong LOS. 27 It remains unclear if EN is therapeutic by promoting coping and soothing during NIV.…”

mentioning

confidence: 99%

Enteral Nutrition Improves Vital Signs in Children With Bronchiolitis on Noninvasive Ventilation

Sochet¹,

Nunez²,

Wilsey

et al. 2021

Hospital Pediatrics

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OBJECTIVES: In children hospitalized for bronchiolitis, enteral nutrition (EN) practices during noninvasive ventilation (NIV) vary widely. We sought to assess the potential impact of EN by observing changes in physiometric indices (heart rate [HR] and respiratory rate [RR]) before and after EN initiation. METHODS: We performed a retrospective cohort study in children <2 years of age hospitalized for bronchiolitis receiving NIV from 2017 to 2019 in a quaternary ICU. The primary outcome was patient HR and RR before and after EN initiation. Descriptive data included demographics, anthropometrics, comorbidities, NIV parameters, EN characteristics, and general hospital outcomes. Analyses included paired comparative and descriptive statistics. RESULTS: Of the 124 children studied, 85 (69%) were permitted EN at a median of 12 (interquartile range [IQR]: 7 to 29) hours. The route was oral (76.5%), nasogastric (15.3%), or postpyloric (8.2%) and was predominantly started during high-flow nasal cannula (71%) at flow rates of 1 (IQR: 0.7 to 1.4) L/kg per minute. After EN initiation, reductions in the median RR (percentage change: −11 [IQR: −23 to 3]; P < .01) and HR (percentage change: −5 [IQR: −12 to 1]; P < .01) were noted. Those permitted EN were younger (5 [IQR: 2 to 11] vs 11 [IQR: 3 to 17] months; P < .01) and more likely to have bronchopulmonary dysplasia (19% vs 5%; P = .04). Malnutrition rates, comorbidities, admission timing, flow rates, length of stay, and NIV duration did not differ for those provided or not provided EN. No aspiration events were observed. CONCLUSIONS: Reductions between pre- and postprandial RR after EN initiation among children hospitalized for bronchiolitis on NIV were observed without clinically significant aspiration. These findings support existing data that suggest that EN is safe during NIV and may lessen distress in some patients.

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Nutritional management of young infants presenting with acute bronchiolitis in Belgium, France and Switzerland: survey of current practices and documentary search of national guidelines worldwide

Cited by 17 publications

References 34 publications

Nasogastric tube, a warning sign for high-flow nasal cannula failure in infants with bronchiolitis

Nasogastric tube, a warning sign for high-flow nasal cannula failure in infants with bronchiolitis

Barriers to Delivery of Enteral Nutrition in Pediatric Intensive Care: A World Survey

Enteral Nutrition Improves Vital Signs in Children With Bronchiolitis on Noninvasive Ventilation

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