Bolus Versus Continuous Nasogastric Feeds for Infants With Bronchiolitis: A Randomized Trial

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Courtney, Alyssa, Bernard, Anne, Burgess, Scott, Davies, Katie, Foster, Kelly, Kapoor, Vishal, Levitt, David and Sly, Peter. 2022. "Bolus Versus Continuous Nasogastric Feeds for Infants With Bronchiolitis: A Randomized Trial." Hospital Pediatrics. 12 (1), pp. 1-8. https://doi.org/10.1542/hpeds.2020-005702
Article Title

Bolus Versus Continuous Nasogastric Feeds for Infants With Bronchiolitis: A Randomized Trial

ERA Journal ID210558
Article CategoryArticle
AuthorsCourtney, Alyssa (Author), Bernard, Anne (Author), Burgess, Scott (Author), Davies, Katie (Author), Foster, Kelly (Author), Kapoor, Vishal (Author), Levitt, David (Author) and Sly, Peter (Author)
Journal TitleHospital Pediatrics
Journal Citation12 (1), pp. 1-8
Number of Pages10
Year2022
Place of PublicationUnited States
ISSN2154-1663
2154-1671
Digital Object Identifier (DOI)https://doi.org/10.1542/hpeds.2020-005702
Web Address (URL)https://publications.aap.org/hospitalpediatrics/article-abstract/12/1/1/183865/Bolus-Versus-Continuous-Nasogastric-Feeds-for?redirectedFrom=fulltext
Abstract

BACKGROUND AND OBJECTIVES: Infants hospitalized with bronchiolitis are commenced on nasogastric feeding to maintain hydration. Feeding strategies vary according to physician or institution preference. The current study hypothesized that continuous nasogastric feeding would prolong length of stay (LOS) when compared to bolus feeding.

METHODS: A randomized, parallel-group, superiority clinical trial was performed within an Australian children’s hospital throughout 2 bronchiolitis seasons from May 2018 to October 2019. Infants <12 months hospitalized with bronchiolitis and requiring supplemental nasogastric feeding were randomly assigned to continuous or bolus nasogastric regimens. LOS was the primary outcome. Secondary outcome measures included pulmonary aspirations and admissions to intensive care.

RESULTS: The intention-to-treat analysis included 189 patients: 98 in the bolus nasogastric feeding group and 91 in the continuous group. There was no significant difference in LOS (median LOS of the bolus group was 54.25 hours [interquartile range 40.25–82] and 56 hours [interquartile range 38–78.75] in the continuous group). A higher proportion of admissions to intensive care was detected in the continuous group (28.57% [26 of 91] of the continuous group vs 11.22% [11 of 98] of the bolus group [P value 0.004]). There were no clinically significant pulmonary aspirations or statistically significant differences in vital signs between the groups within 6 hours of feed initiation.

CONCLUSIONS: No significant difference in LOS was found between bolus and continuous nasogastric feeding strategies for infants hospitalized with bronchiolitis. The continuous feeding group had a higher proportion of intensive care admissions, and there were no aspiration events.

KeywordsBronchiolitis, Hospital Medicine, Nutrition
ANZSRC Field of Research 2020420501. Acute care
Byline AffiliationsDepartment of Health, Queensland
University of Queensland
School of Nursing and Midwifery
Institution of OriginUniversity of Southern Queensland
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