Nutritional management of young infants presenting with acute bronchiolitis in Belgium, France and Switzerland: survey of current practices and documentary search of national guidelines worldwide.

Détails

ID Serval
serval:BIB_8A584F462B9C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Nutritional management of young infants presenting with acute bronchiolitis in Belgium, France and Switzerland: survey of current practices and documentary search of national guidelines worldwide.
Périodique
European journal of pediatrics
Auteur⸱e⸱s
Valla F.V., Baudin F., Demaret P., Rooze S., Moullet C., Cotting J., Ford-Chessel C., Pouyau R., Peretti N., Tume L.N., Milesi C., Le Roux B.G.
ISSN
1432-1076 (Electronic)
ISSN-L
0340-6199
Statut éditorial
Publié
Date de publication
03/2019
Peer-reviewed
Oui
Volume
178
Numéro
3
Pages
331-340
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Feeding difficulties are common in young infants presenting with acute bronchiolitis, but limited data is available to guide clinicians adapting nutritional management. We aimed to assess paediatricians' nutritional practices among Western Europe French speaking countries. A survey was disseminated to describe advice given to parents for at home nutritional support, in hospital nutritional management, and preferred methods for enteral nutrition and for intravenous fluid management. A documentary search of international guidelines was concomitantly conducted. Ninety-three (66%) contacted physicians responded. Feeding difficulties were a common indication for infants' admission. Written protocols were rarely available. Enteral nutrition was favoured most of the time when oral nutrition was insufficient and might be withheld in case of severe dyspnoea to decrease respiratory workload. Half of physicians were aware of hyponatremia risk and pathophysiology, and isotonic intravenous solutions were used in less than 15% of centres. International guideline search (23 countries) showed a lack of detailed nutritional management recommendations in most of them.Conclusion: practices were inconsistent among physicians. Guidelines detailed nutritional management poorly. Awareness of hyponatremia risk in relation to intravenous hypotonic fluids and of the safety of enteral hydration and nutrition is insufficient. New guidelines including detailed nutritional management recommendations are urgently needed. What is Known? • Infants presenting with acute bronchiolitis face feeding difficulties. • Underfeeding may promote undernutrition, and intravenous hydration with hypotonic fluids may induce hyponatremia. What is New? • Physicians' nutritional practices are inconsistent and awareness of hyponatremia risk and pathophysiology is insufficient among physicians. • Awareness of hyponatremia risk and pathophysiology is insufficient among physicians. • The reasons for enteral nutrition withholding in bronchiolitis infants are not evidence based, and national guidelines of acute bronchiolitis across the world are elusive regarding nutritional management. • National guidelines of acute bronchiolitis across the world are elusive regarding nutritional management.
Mots-clé
Acute Disease, Belgium, Bronchiolitis/therapy, Cross-Sectional Studies, Fluid Therapy/adverse effects, Fluid Therapy/methods, Fluid Therapy/statistics & numerical data, France, Health Care Surveys, Humans, Infant, Infant, Newborn, Nutritional Support/adverse effects, Nutritional Support/methods, Nutritional Support/statistics & numerical data, Practice Guidelines as Topic, Practice Patterns, Physicians'/statistics & numerical data, Switzerland, Bronchiolitis, clinical practice, Child, Nutrition, Recommendation
Pubmed
Web of science
Création de la notice
05/01/2019 17:06
Dernière modification de la notice
20/08/2019 14:49
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