Nasogastric versus intravenous therapy in the treatment of bronchiolitis
| Citation | Study group | Study type | Outcome | Key results | Comments |
|---|---|---|---|---|---|
| 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 treatment | Uncontrolled cohort (level 4) | Respiratory and heart rate, SaO2 Number going on to iv fluids | NGT “tolerated without incident” 2/37 deteriorated as illness progressed. Removal of NGT did not help | Uncontrolled case series Excluded children <4 months |
| Vogel et al (2003) | 409 infants in 5 New Zealand hospitals | Uncontrolled cohort (level 4) | Percentage receiving i.v. or NGT fluids in each hospital | 15–30% received iv fluids 1–39% received NGT fluids | Uncontrolled 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-situ | Controlled 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 NGT | Study 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 NGT | Nasal TV decreased from 54% to 39% with NGT in place Total TV remained constant despite NGT | Small 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 resistance | Reduced minute volume, increased pulmonary resistance in <2 kg group with NGT. No effect vs. OGT in babies >2 kg | Study only of “well” neonates, up to 3 kg without lung disease |