• J Hosp Med · Nov 2024

    Multicenter Study Observational Study

    Parenteral versus enteral fluids for infants hospitalized with bronchiolitis: The PREFER shared decision-making prospective observational study protocol.

    • Peter J Gill, Francine Buchanan, Christine Fahim, Cornelia M Borkhoff, Shamama Raza, Melanie Buba, Gita Wahi, Ann Bayliss, Kim Zhou, Ronik Kanani, Mahmoud Sakran, Kim De Castris-Garcia, Nicholas Barrowman, Terry Klassen, Suzanne Schuh, Jessie Hulst, Sharon Straus, Colin Macarthur, Aubrey Sozer, Glyn Elwyn, Karen Breen-Reid, Sanjay Mahant, and Canadian Pediatric Inpatient Research Network (PIRN).
    • Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
    • J Hosp Med. 2024 Nov 1; 19 (11): 109010991090-1099.

    IntroductionIncorporating shared decision-making (SDM) with children and families in hospitals was a top priority identified by patients, caregivers, and clinicians. Bronchiolitis, a common and costly reason for hospitalization in children, is an exemplar condition to study SDM in hospitals. Internationally, clinical practice guidelines differ when recommending intravenous (IV or parenteral) or nasogastric (NG or enteral) fluids for hospitalized infants with bronchiolitis who are unsafe to be fed orally. While evidence indicates that either IV or NG fluids are safe and effective, parent involvement in SDM in selecting IV or NG fluids is unknown. Our aim is to generate knowledge of SDM with parents in choosing between IV or NG fluids and the benefits and harms of these two treatment options for hospitalized children with bronchiolitis.MethodThis is a multicenter, prospective, observational study, including children aged <12 months admitted to hospital with bronchiolitis requiring supplemental IV or NG fluids. The primary outcome will evaluate the extent of SDM in choosing IV versus NG fluids using the validated CollaboRATE tool. Secondary outcomes include the proportion of parents provided a choice of IV versus NG fluids; parent knowledge of fluid therapy; rate of fluids; length of hospital stay; and complications.DiscussionThis study will evaluate the extent of SDM in hospitalized infants with bronchiolitis who require IV or NG fluids and will evaluate both patient-centered and clinical outcomes that are relevant to clinical practice.© 2024 The Author(s). Journal of Hospital Medicine published by Wiley Periodicals LLC on behalf of Society of Hospital Medicine.

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