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J Pediatr. 2016 Nov;178:241-245.e1. doi: 10.1016/j.jpeds.2016.07.012. Epub 2016 Aug 10.

Nasogastric Hydration in Infants with Bronchiolitis Less Than 2 Months of Age.

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Department of Emergency Medicine, Royal Children's Hospital Victoria, Parkville, Victoria, Australia. Electronic address:
Department of Emergency Medicine, Royal Children's Hospital Victoria, Parkville, Victoria, Australia.
Department of Emergency Medicine and Pediatrics, Sunshine Hospital, St Albans, Victoria, Australia.
Department of Emergency Medicine, Monash Medical Centre, Clayton, Victoria, Australia.
Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia.



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.


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.


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).


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.


bronchiolitis; hydration; respiratory syncytial virus

[Indexed for MEDLINE]

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