A Randomized Trial of Oral vs Intravenous Rehydration in a Pediatric Emergency Department

Abstract

Reported barriers to ORT were not supported by our data. Moreover, ORT performed better than intravenous therapy on all measured outcomes.

The Use of a Triage-Based Protocol for Oral Rehydration in a Pediatric Emergency Department

“…This low tolerance of formal rehydration is likely attributable to the effects of ondansetron, which decreased ongoing vomiting and obviated the use of small, timed quantities of oral fluid. Despite the use of a less formal approach to oral rehydration, the 2.5% rate of hospital admission in this study was lower than the 11% reported with the use of formal rehydration without antiemetics by Atherly-John, et al[4] That study reported no patients requiring unscheduled return to care on 2–4 day follow-up, in contrast to our rates of 15% pre- and 19% post-intervention. However, the difference in admission rates and the fact that our follow-up calls were made at least one week after the ED visit render these results difficult to compare.…”

“…The initial protocol for this study was designed to mimic formal oral rehydration approaches described in the literature,[4] with frequent, small doses of rehydration solution for patients who had any clinical dehydration. However, we found this approach to be poorly tolerated in our patient population.…”

The Use of a Triage-Based Protocol for Oral Rehydration in a Pediatric Emergency Department

“…This low tolerance of formal rehydration is likely attributable to the effects of ondansetron, which decreased ongoing vomiting and obviated the use of small, timed quantities of oral fluid. Despite the use of a less formal approach to oral rehydration, the 2.5% rate of hospital admission in this study was lower than the 11% reported with the use of formal rehydration without antiemetics by Atherly-John, et al[4] That study reported no patients requiring unscheduled return to care on 2–4 day follow-up, in contrast to our rates of 15% pre- and 19% post-intervention. However, the difference in admission rates and the fact that our follow-up calls were made at least one week after the ED visit render these results difficult to compare.…”

“…The initial protocol for this study was designed to mimic formal oral rehydration approaches described in the literature,[4] with frequent, small doses of rehydration solution for patients who had any clinical dehydration. However, we found this approach to be poorly tolerated in our patient population.…”

Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials

“…14 studies met the inclusion criteria [16,17,23,29-39]; one study stratified their data by two sites (USA and Panama) and we treated this as two studies in the quantitative analysis [23]. …”

“…The average quality score was 2; allocation concealment was adequate in one study [39] and unclear in the others. Six studies received funding/sponsorship from the pharmaceutical industry [16,17,23,29,32,38].…”

Use of Bedside Ultrasound to Assess Degree of Dehydration in Children With Gastroenteritis

“…Oral rehydration therapy has been found to be a good alternative to intravenous rehydration in children with mild to moderate dehydration 1,12,13 . A significant proportion of our study subjects received intravenous fluid as part of their treatment in the PED.…”

The Use of a Triage-Based Protocol for Oral Rehydration in a Pediatric Emergency Department

“…This low tolerance of formal rehydration is likely attributable to the effects of ondansetron, which decreased ongoing vomiting and obviated the use of small, timed quantities of oral fluid. Despite the use of a less formal approach to oral rehydration, the 2.5% rate of hospital admission in this study was lower than the 11% reported with the use of formal rehydration without antiemetics by Atherly-John, et al[4] That study reported no patients requiring unscheduled return to care on 2–4 day follow-up, in contrast to our rates of 15% pre- and 19% post-intervention. However, the difference in admission rates and the fact that our follow-up calls were made at least one week after the ED visit render these results difficult to compare.…”

“…The initial protocol for this study was designed to mimic formal oral rehydration approaches described in the literature,[4] with frequent, small doses of rehydration solution for patients who had any clinical dehydration. However, we found this approach to be poorly tolerated in our patient population.…”

Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials

“…14 studies met the inclusion criteria [16,17,23,29-39]; one study stratified their data by two sites (USA and Panama) and we treated this as two studies in the quantitative analysis [23]. …”

“…The average quality score was 2; allocation concealment was adequate in one study [39] and unclear in the others. Six studies received funding/sponsorship from the pharmaceutical industry [16,17,23,29,32,38].…”

Use of Bedside Ultrasound to Assess Degree of Dehydration in Children With Gastroenteritis

“…Oral rehydration therapy has been found to be a good alternative to intravenous rehydration in children with mild to moderate dehydration 1,12,13 . A significant proportion of our study subjects received intravenous fluid as part of their treatment in the PED.…”

The Use of a Triage-Based Protocol for Oral Rehydration in a Pediatric Emergency Department

“…This low tolerance of formal rehydration is likely attributable to the effects of ondansetron, which decreased ongoing vomiting and obviated the use of small, timed quantities of oral fluid. Despite the use of a less formal approach to oral rehydration, the 2.5% rate of hospital admission in this study was lower than the 11% reported with the use of formal rehydration without antiemetics by Atherly-John, et al[4] That study reported no patients requiring unscheduled return to care on 2–4 day follow-up, in contrast to our rates of 15% pre- and 19% post-intervention. However, the difference in admission rates and the fact that our follow-up calls were made at least one week after the ED visit render these results difficult to compare.…”

“…The initial protocol for this study was designed to mimic formal oral rehydration approaches described in the literature,[4] with frequent, small doses of rehydration solution for patients who had any clinical dehydration. However, we found this approach to be poorly tolerated in our patient population.…”

Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials

“…14 studies met the inclusion criteria [16,17,23,29-39]; one study stratified their data by two sites (USA and Panama) and we treated this as two studies in the quantitative analysis [23]. …”

“…The average quality score was 2; allocation concealment was adequate in one study [39] and unclear in the others. Six studies received funding/sponsorship from the pharmaceutical industry [16,17,23,29,32,38].…”

Use of Bedside Ultrasound to Assess Degree of Dehydration in Children With Gastroenteritis

“…Oral rehydration therapy has been found to be a good alternative to intravenous rehydration in children with mild to moderate dehydration 1,12,13 . A significant proportion of our study subjects received intravenous fluid as part of their treatment in the PED.…”