{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:51:56Z","timestamp":1782867116782,"version":"3.54.5"},"reference-count":36,"publisher":"American Academy of Pediatrics (AAP)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Nasogastric (NG) fluid replacement is an effective and nutritionally beneficial alternative to intravenous (IV) hydration for pediatric inpatients with bronchiolitis. Existing evidence demonstrates equipoise in the use of NG vs IV hydration; however, interinstitutional data on NG hydration utilization are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>To describe NG hydration in bronchiolitis across institutions and its association with clinical factors and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This observational multicenter substudy of the Eliminating Monitor Overuse (EMO) Trial collected data on fluid replacement for pediatric inpatients. Children aged 2 through 23\u00a0months with bronchiolitis between January and May 2023 were included. Those with extreme prematurity, apnea or cyanosis, or comorbid conditions that could impact pulse oximetry use were excluded. We measured NG and IV utilization rates over all encounters and then measured institution-specific rates in patients receiving either NG or IV hydration. Maximum respiratory support, intensive care unit (ICU) stay, and neurologic impairment (NI) were compared between NG and IV cohorts. Multivariable models examined factors associated with NG hydration and length of stay (LOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Our substudy included 1707 observations from 33 hospitals. Overall NG utilization was 7%, and IV use was 52%. Among patients who received either NG or IV hydration, institution-specific NG utilization ranged from 0% to 70%. Patients on mechanical ventilation, in the ICU, and with NI were more likely to receive NG hydration. LOS was 1.83-fold longer (95% CI, 1.62\u20132.06) for patients who received NG compared with IV hydration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>We found overall low use of NG hydration, with wide between-hospital variation. Children who experienced critical illness and NI were more likely to receive NG hydration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/hpeds.2025-008635","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:02:56Z","timestamp":1781049776000},"page":"600-609","source":"Crossref","is-referenced-by-count":0,"title":["Nasogastric Hydration Utilization in Bronchiolitis, an EMO Trial Observational Substudy"],"prefix":"10.1542","volume":"16","author":[{"given":"Brandy M.","family":"Hoyt","sequence":"first","affiliation":[{"name":"1Department of Pediatrics, Section of Hospital Medicine, Children\u2019s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Thomas","sequence":"additional","affiliation":[{"name":"2Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Tyler","sequence":"additional","affiliation":[{"name":"3Department of Pediatrics, Nationwide Children\u2019s Hospital and The Ohio State University College of Medicine, Columbus, Ohio"},{"name":"4Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Center for Child Health Equity and Outcomes Research, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Temte","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Section of Hospital Medicine, Children\u2019s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"McMahon","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Section of Hospital Medicine, Children\u2019s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Watson","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Section of Hospital Medicine, Children\u2019s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Bonafide","sequence":"additional","affiliation":[{"name":"5Section of Hospital Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania;"},{"name":"6Clinical Futures, a Center of Emphasis within the CHOP Research Institute, Children\u2019s Hospital of Philadelphia, Philadelphia;"},{"name":"7Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"8Penn Implementation Science Center (PISCE), University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinad 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