OP-023 Feasibility of short enteral feeding for bronchiolitis to avoid hospitalization

• Published in: BMJ paediatrics open Vol. 8; no. Suppl 5; p. A10
• Main Authors: Amandine, Gaudin, Aude, Peralta, Chadia, Toumi, Sabine, Finci, Tossavi, Agodomou, Come, Horvat, Tom, Toin, Elsa, Masson, Luc, Panetta, Antoine, Ouziel, Matthieu, Receveur, Ellia, Mezgueldi, Marie-Hélène, Déal, Philippe, Cheyssac, Carine, Chassery, Aymeric, Cantais, Elise, Launay, Cécile, Guiheneuf, Etienne, Javouhey, Julie, Haesebaert, Jean-Sebastien, Casalegno, Yves, Gillet, Dominique, Ploin
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.07.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Bronchiolitis; Emergency department; Enteral feeding; Enteral nutrition; Healthcare organization; Hospitalization; Nutrition; Nutritionnal impairment; Oral Presentation; Pediatrics
• ISSN: 2399-9772
• DOI: 10.1136/bmjpo-2024-EPAC.23

AimEvery winter, bronchiolitis epidemic challenge the pediatric hospital capacity. Our pediatric emergency room (PER) initiated a short-term enteral nutrition protocol (STENP) for infants presenting a bronchiolitis with exclusive nutritional impairment. We conducted a retrospective study to evaluate its feasibility, safety, efficacy, and utility.Material and MethodInfants with exclusive-digestive-phenotype of bronchiolitis were proposed for STENP during 2 winters. Inclusion criteria were respiratory symptoms for ≥72 hours, nutritional impairment, and 8–51 weeks of age. Exclusion criteria were respiratory, hemodynamic, or neurological impairment, chronic condition/malnutrition. Patients underwent an enteral nutrition with nasogastric tube during 6 hours, with continuous respiratory and adverse event monitoring. Outcomes were hospitalization after STENP, tolerance, feasibility, and early/late secondary hospitalization evaluated at day 3 or 28.Results93 children received the STENP (31 exclusions). 60 children (64.5%) were discharged after protocol (table 1). Among 33 hospitalizations, 28 (30.1%) were admitted for a respiratory reason (hypoxemia, respiratory distress) and 5 (5.4%) for a digestive reason (vomiting). Among 60 discharges, 4 presented early secondary hospitalization (n=3 digestive reasons, n=1 respiratory reason). One infant had a late hospitalization for a digestive reason). We observed nineteen side effects (20.4%). All consisted in displacement of the nasogastric tube without further consequence. There was no major side effect. Utility for the patient/for hospital are discussed (table 1) for each situation of primary discharge, primary and secondary hospitalization.Abstract OP-023 Table 1Outcomes of the study, and categorization of the utility for the patient and for the hospital (resp.: respiratory; nutr.: nutritional).ConclusionsSTENP in the PER for exclusive-digestive-form of bronchiolitis seems promising: giving time for surveillance and demasking respiratory impairment, allowing discharge with few failures and sufficient safety. More than one half of the infants could be discharged without further readmission showing utility per se. Cases of secondary nutritional impairment highlight the interest in continuing enteral nutrition at home for some cases. The usefulness of STENP in reducing the in-hospital burden during the epidemic period is a major point of our study.