Bronchiolitis Feeding
Bronchiolitis Clinical Pathway Committee recommendation: Based on very low quality evidence, a conditional recommendation is made for otherwise healthy patients who were receiving oral feeds prior to admission for bronchiolitis to continue to be offered oral feeds while on high or low-flow nasal cannula. Additional considerations should be taken for patients with history of prematurity, co-morbidities, or history of aspiration events.
Literature supporting this recommendation: Seven cohort studies showed that aspiration events were rare in hospitalized patients with bronchiolitis receiving treatment with HFNC (two events in 1,816 patients). The seven included studies did not use respiratory rate alone as a basis for the decision of whether to feed orally.
Critically Appraised Topic (CAT): Oral Feeding for Hospitalized Patients with Bronchiolitis
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.