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OP-023 Feasibility of short enteral feeding for bronchiolitis to avoid hospitalization
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  1. Gaudin Amandine1,
  2. Peralta Aude1,
  3. Toumi Chadia1,
  4. Finci Sabine1,
  5. Agodomou Tossavi1,
  6. Horvat Come1,
  7. Toin Tom2,
  8. Masson Elsa1,
  9. Panetta Luc1,
  10. Ouziel Antoine1,
  11. Receveur Matthieu1,
  12. Mezgueldi Ellia1,
  13. Déal Marie-Hélène1,
  14. Cheyssac Philippe3,
  15. Chassery Carine3,
  16. Cantais Aymeric4,
  17. Launay Elise5,
  18. Guiheneuf Cécile6,
  19. Javouhey Etienne1,
  20. Haesebaert Julie7,
  21. Casalegno Jean-Sebastien8,
  22. Gillet Yves1,
  23. Ploin Dominique1
  1. 1Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de Réanimation Pédiatrique et d’Accueil des Urgences and Kids’ Lyon Infectious diseases Team (KIDs’LIT), Bron, France
  2. 2Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de pneumologie, allergologie, mucoviscidose, Bron, France
  3. 3Hospitalisation à domicile, Groupe Adène, Établissement d’HAD pédiatrique de Lyon, Lyon, France
  4. 4CHU de Saint Etienne, Service d’urgence Pédiatrique, Saint Etienne, France
  5. 5CHU de Nantes, Hôpital femme-enfant-adolescent, Hôpital enfant – adolescent pédiatrie, Nantes, France
  6. 6Association Française de Pédiatrie Ambulatoire, Orléans, France
  7. 7Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, Lyon, France
  8. 8Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Virologie, Lyon, France

Abstract

Aim Every 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 Method Infants 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.

Results 93 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 1

Conclusions STENP 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.

  • Bronchiolitis
  • Nutritionnal impairment
  • Enteral feeding
  • Emergency department
  • Healthcare organization

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