Comparitive Rehydration in Bronchiolitis

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The need for supplying fluids in paediatric bronchiolitis (severe viral airway infection of the infant) is frequent, and is the consequence of reduced feeding, sweating, and fever., There are currently 2 means of supplying fluids, intravenous or nasogastric. Nasogastric rehydration (NR) means giving fluids through a feeding tube inserted through the nostrils into the stomach thus eliminating the effort of drinking. It is generally effective and has few complications. Intra venous rehydration (IR) means giving fluids directly into a vein through a drip. It is often difficult to insert a drip in this particular age group, whereas the nasal feeding tube is generally easier to insert. The potential complications of IR are water overload and electrolyte imbalances. The main possible complications of NR is vomiting. The role of NR in bronchiolitis is, however, controversial. It is, for example, an accepted treatment in Scandinavia and Switzerland, whereas IR is the accepted treatment at the RCH Melbourne. Even within Australia there is no standard of care as such among the different hospitals with most hospitals using a combination of NR and IR, without any guidelines. The little existing evidence shows that NR in bronchiolitis is safe and well tolerated. The major concern raised with NR is the partial obstruction of the airway, by cousing ablockage of the nostril in young children who mostly breathe through the nose, thus theoretically causing further breathing problems. But its clinical significance, especially in bronchiolitis, is not clear and has not been the subject of clinical trials. In this prospective study we will compare Nasogastric and Intravenous treatment in bronchiolitis.

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