Nutrition and High-Flow Nasal Cannula Respiratory Support in Children With Bronchiolitis

Katherine N. Slain, Natalia Martinez-Schlurmann, Steven L. Shein, Anne Stormorken

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVES: No guidelines are available regarding initiation of enteral nutrition in children with bronchiolitis on high-flow nasal cannula (HFNC) support. We hypothesized that the incidence of feeding-related adverse events (AEs) would not be associated with HFNC support.

METHODS: This retrospective study included children ≤24 months old with bronchiolitis receiving HFNC in a PICU from September 2013 through April 2014. Data included demographics, respiratory support during feeding, and feeding-related AEs. Feeding-related AEs were extracted from nursing documentation and defined as respiratory distress or emesis. Feed route and maximum HFNC delivery were recorded in 8-hour shifts (6 am-2 pm, 2 pm-10 pm, and 10 pm-6 am).

RESULTS: 70 children were included, with a median age of 5 (interquartile range [IQR] 2-10) months. HFNC delivery at feed initiation varied widely, and AEs related to feeding occurred rarely. Children were fed in 501 of 794 (63%) of nursing shifts, with AEs documented in only 29 of 501 (5.8%) of those shifts. The incidence of AEs at varying levels of respiratory support did not differ (P = .092). Children in the "early feeding" (fed within first 2 shifts) group (n = 22) had a shorter PICU length of stay (2.2 days [IQR 1.4-3.9] vs 3.2 [IQR 2.5-5.3], P = .006) and shorter duration of HFNC use (26.0 hours [IQR 15.8-57.0] vs 53.5 [IQR 37.0-84.8], P = .002), compared with children in the "late feeding" group (n = 48).

CONCLUSIONS: In this small, single-institution patient cohort, feeding-related AEs were rare and not related to the delivered level of respiratory support.

Original languageEnglish (US)
Pages (from-to)256-262
Number of pages7
JournalHospital pediatrics
Volume7
Issue number5
DOIs
StatePublished - May 1 2017
Externally publishedYes

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Bronchiolitis
Nursing
Incidence
Enteral Nutrition
Documentation
Vomiting
Cannula
Length of Stay
Retrospective Studies
Demography
Guidelines

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Nutrition and High-Flow Nasal Cannula Respiratory Support in Children With Bronchiolitis. / Slain, Katherine N.; Martinez-Schlurmann, Natalia; Shein, Steven L.; Stormorken, Anne.

In: Hospital pediatrics, Vol. 7, No. 5, 01.05.2017, p. 256-262.

Research output: Contribution to journalArticle

Slain, KN, Martinez-Schlurmann, N, Shein, SL & Stormorken, A 2017, 'Nutrition and High-Flow Nasal Cannula Respiratory Support in Children With Bronchiolitis', Hospital pediatrics, vol. 7, no. 5, pp. 256-262. https://doi.org/10.1542/hpeds.2016-0194
Slain, Katherine N. ; Martinez-Schlurmann, Natalia ; Shein, Steven L. ; Stormorken, Anne. / Nutrition and High-Flow Nasal Cannula Respiratory Support in Children With Bronchiolitis. In: Hospital pediatrics. 2017 ; Vol. 7, No. 5. pp. 256-262.
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N2 - OBJECTIVES: No guidelines are available regarding initiation of enteral nutrition in children with bronchiolitis on high-flow nasal cannula (HFNC) support. We hypothesized that the incidence of feeding-related adverse events (AEs) would not be associated with HFNC support.METHODS: This retrospective study included children ≤24 months old with bronchiolitis receiving HFNC in a PICU from September 2013 through April 2014. Data included demographics, respiratory support during feeding, and feeding-related AEs. Feeding-related AEs were extracted from nursing documentation and defined as respiratory distress or emesis. Feed route and maximum HFNC delivery were recorded in 8-hour shifts (6 am-2 pm, 2 pm-10 pm, and 10 pm-6 am).RESULTS: 70 children were included, with a median age of 5 (interquartile range [IQR] 2-10) months. HFNC delivery at feed initiation varied widely, and AEs related to feeding occurred rarely. Children were fed in 501 of 794 (63%) of nursing shifts, with AEs documented in only 29 of 501 (5.8%) of those shifts. The incidence of AEs at varying levels of respiratory support did not differ (P = .092). Children in the "early feeding" (fed within first 2 shifts) group (n = 22) had a shorter PICU length of stay (2.2 days [IQR 1.4-3.9] vs 3.2 [IQR 2.5-5.3], P = .006) and shorter duration of HFNC use (26.0 hours [IQR 15.8-57.0] vs 53.5 [IQR 37.0-84.8], P = .002), compared with children in the "late feeding" group (n = 48).CONCLUSIONS: In this small, single-institution patient cohort, feeding-related AEs were rare and not related to the delivered level of respiratory support.

AB - OBJECTIVES: No guidelines are available regarding initiation of enteral nutrition in children with bronchiolitis on high-flow nasal cannula (HFNC) support. We hypothesized that the incidence of feeding-related adverse events (AEs) would not be associated with HFNC support.METHODS: This retrospective study included children ≤24 months old with bronchiolitis receiving HFNC in a PICU from September 2013 through April 2014. Data included demographics, respiratory support during feeding, and feeding-related AEs. Feeding-related AEs were extracted from nursing documentation and defined as respiratory distress or emesis. Feed route and maximum HFNC delivery were recorded in 8-hour shifts (6 am-2 pm, 2 pm-10 pm, and 10 pm-6 am).RESULTS: 70 children were included, with a median age of 5 (interquartile range [IQR] 2-10) months. HFNC delivery at feed initiation varied widely, and AEs related to feeding occurred rarely. Children were fed in 501 of 794 (63%) of nursing shifts, with AEs documented in only 29 of 501 (5.8%) of those shifts. The incidence of AEs at varying levels of respiratory support did not differ (P = .092). Children in the "early feeding" (fed within first 2 shifts) group (n = 22) had a shorter PICU length of stay (2.2 days [IQR 1.4-3.9] vs 3.2 [IQR 2.5-5.3], P = .006) and shorter duration of HFNC use (26.0 hours [IQR 15.8-57.0] vs 53.5 [IQR 37.0-84.8], P = .002), compared with children in the "late feeding" group (n = 48).CONCLUSIONS: In this small, single-institution patient cohort, feeding-related AEs were rare and not related to the delivered level of respiratory support.

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