Enteral vs Intravenous Rehydration Therapy for Children With Gastroenteritis

Abstract

For childhood gastroenteritis, enteral rehydration is as effective if not better than IV rehydration. Enteral rehydration by the oral or nasogastric route is associated with significantly fewer major adverse events and a shorter hospital stay compared with IV therapy and is successful in most children.

Efficacy and safety of a new apple‐flavoured oral rehydration solution in children with acute gastroenteritis: a double‐blind randomized controlled trial

“…In our study, in the overall population, treatment failure, that is, the need for unscheduled intravenous rehydration, was approximately 6%. This is in line with previously published data documenting that the overall failure rate of enteral therapy is 4% (95% CI 3.0%–5.0%) (9). Thus, our results indicate that oral rehydration therapy was successful in the majority of children with AGE if defined as no need for unscheduled intravenous rehydration (and thus hospitalization).…”

Evaluating the Impact of Clinical Decision Tools in Pediatric Acute Gastroenteritis: A Population‐based Cohort Study

“…A key positive finding from our study is that the presence of a medical directive for nursing initiation of ORT at triage is associated with fewer return visits. This reinforces evidence from randomized controlled trials that supports the use of ORT in mild to moderate AGE . While there is a paucity of research on the impact of triage‐based ORT medical directive on return visits, previous work has found that pathways encouraging ORT can reduce length of stay .…”

The Management of Children with Gastroenteritis and Dehydration in the Emergency Department

“…The authors caution that these results may be applicable only to children with dehydration from diarrhea and not necessarily to children with gastroenteritis (i.e., vomiting and diarrhea), although the risk difference for trials between enteral rehydration and intravenous therapy that included children who had persistent vomiting was 4% (95% CI Ϫ5-13) compared to 0% (95% CI Ϫ3-3) for children enrolled in trials that excluded persistently vomiting patients (45). This enteral failure rate is similar to previously published failure rates reported in meta-analyses (55,56).…”