BOSTON – Nasogastric feeding is safe and feasible for infants with viral bronchiolitis.
Infants who received nutrition by NG tube did not experience any exacerbation of their respiratory illness and recovered just as quickly as those who received intravenous fluids, Dr. Amir Kugelman said at the annual meeting of the Pediatric Academic Societies.
Michele G Sullivan/IMNG Medical Media
Dr. Amir Kugelman
Although his randomized controlled study wasn’t designed to evaluate nutritional outcomes, Dr. Kugelman, director of the pediatric pulmonary unit at Bnai Zion Medical Center, Haifa, Israel, said that NG feeding offers some advantages over intravenous fluids.
Intravenous fluids provide limited calories and no lipids or proteins, which can lead to a catabolic state during a time of increased nutritional needs. "Gastric tube feeding is more physiologic and allows mothers to continue breast-feeding" while their infant is unable to tolerate oral intake, said Dr. Kugelman. "There is also the possibility that better nutrition might enhance recovery."
His study included 51 infants (mean age, 2.5 months) who had moderate viral bronchiolitis. They could not sustain oral feeding because of an increased respiratory rate of at least 60 breaths per minute. Most of them (41) were positive for respiratory syncytial virus; 11 had developed pneumonia. There were no significant baseline differences except for length of illness – those randomized to the intravenous group had been ill an average of 4 days, compared with 3 days in the NG group.
The IV group received a continuous infusion of a standard 5% dextrose in normal saline solution. The NG group received a slow drip of breast milk or infant formula. Three infants on NG feeds were switched to IV because of vomiting, and one on an IV was switched to NG feeds because of poor IV access and fluid extravasation.
There were no significant differences in the duration of oxygen needed, the time to full oral feeds, or the length of stay, Dr. Kugelman said. There were no incidences of aspiration. Infants in the IV group had a trend toward a shorter length of stay (100 hours vs. 120 hours), but this is probably because they had a longer duration of illness before hospitalization, he said.
Dr. Kugelman had no financial disclosures.