Table 1

 Nasogastric versus intravenous therapy in the treatment of bronchiolitis

CitationStudy groupStudy typeOutcomeKey resultsComments
Sammartino et al (2002)73 Australian infants admitted with bronchiolitis, 55 needing fluids. 37 given fluids by NGT. 18 infants needing fluids were excluded as <4 months or reduced level of consciousness or apnoea or GO reflux needing treatmentUncontrolled cohort (level 4)Respiratory and heart rate, SaO2 Number going on to iv fluidsNGT “tolerated without incident” 2/37 deteriorated as illness progressed. Removal of NGT did not helpUncontrolled case series Excluded children <4 months
Vogel et al (2003)409 infants in 5 New Zealand hospitalsUncontrolled cohort (level 4)Percentage receiving i.v. or NGT fluids in each hospital15–30% received iv fluids 1–39% received NGT fluidsUncontrolled series. No comparison of outcome of NGT vs. i.v. Large variations in practice
Stocks (1980)7 preterm infants (1.6–2.2 kg) measured with and without an NGT in-situControlled physiological study (level 5)Nasal resistance [Rn] (measured in 7) and total airway resistance [Raw] (measured in 4)Increased Rn of 50–150% with NGT in situ. 30–50% increase in Raw with NGTStudy only of “well” preterm infants. No comment on clinical effects. Small study. Considerable measurement difficulties
Martin et al (1988)8 preterm infants (1220–1740 g)Controlled physiological study (level 5)Change in oral/nasal airflow (measured as % total tidal volume [TV]) with and without NGTNasal TV decreased from 54% to 39% with NGT in place Total TV remained constant despite NGTSmall study of “well” neonates without significant lung disease
Greenspan et al (1990)14 neonates <2 kg, 10 neonates >2 kg with either NG or orogastric tube (OGT)Controlled physiological study (level 5)Minute volume, pulmonary resistanceReduced minute volume, increased pulmonary resistance in <2 kg group with NGT. No effect vs. OGT in babies >2 kgStudy only of “well” neonates, up to 3 kg without lung disease