Rapid Intravenous Rehydration to Correct Dehydration and Resolve Vomiting in Children with Acute Gastroenteritis

Azarfar, Anoush; Ravanshad, Yalda; Keykhosravi, Aghillolah; Bagheri, Sepideh; Gharashi, Ziaoddin; Esmaeeli, Mohammad

doi:10.5505/1304.7361.2014.66049

Cited by 6 publications

(10 citation statements)

References 11 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All the eligible RCTs [ 18 – 20 ] were identified through the database search. Two of the included studies [ 18 , 19 ] were conducted in resource-rich countries.…”

Section: Resultsmentioning

confidence: 99%

“…Canada and the USA respectively. While the third [ 20 ] was conducted in Iran. The characteristics of the included studies are summarised in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“… Interventions 50 mL/kg of normal saline IV administered for 1 h (ultra rapid IV hydration) or 50 mL/kg normal saline IV for 3 h (standard hydration) Allocation 1:1 Outcomes Efficacy of treatment by assessing Success and timing of rehydration, study failures (defined as requirement for admission), output (urine, emesis, stool) during the treatment phase, pre- and post treatment laboratory abnormalities, number of return visits, and whether serious complications occurred. Azarfar 2014 [ 20 ] Methods Randomised controlled trial conducted in the emergency department in a tertiary centre (Tabriz children’s hospital) in Tabriz, North-West of Iran. Objective To evaluate the effect of rapid intra- venous rehydration to resolve vomiting in children with acute gastroenteritis.…”

Section: Resultsmentioning

confidence: 99%

“…Only one study [ 18 ] was rated as having low risk of bias while the other two studies [ 19 , 20 ] were rated as being of lower methodological quality. The risk of bias assessment for all 3 included studies is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Azarfar [ 20 ]: At two hours following commencement of intravenous fluid therapy, 63/75 (84%) of children (rapid rehydration group) versus 62/75 (82%) in the standard group were considered as rehydrated or had resolved their vomiting and were thus discharged ( p ≥ 0.05). Two subjects in the intervention group and none in the standard group required readmission following discharge.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Rapid intravenous rehydration of children with acute gastroenteritis and dehydration: a systematic review and meta-analysis

et al. 2018

View full text Add to dashboard Cite

BackgroundThe World Health Organization (WHO) recommends rapid intravenous rehydration, using fluid volumes of 70-100mls/kg over 3–6 h, with some of the initial volume given rapidly as initial fluid boluses to treat hypovolaemic shock for children with acute gastroenteritis (AGE) and severe dehydration. The evidence supporting the safety and efficacy of rapid versus slower rehydration remains uncertain.MethodsWe conducted a systematic review of randomised controlled trials (RCTs) on 11th of May 2017 comparing different rates of intravenous fluid therapy in children with AGE and moderate or severe dehydration, using standard search terms. Two authors independently assessed trial quality and extracted data. Non-RCTs and non-English articles were excluded. The primary endpoint was mortality and secondary endpoints included adverse events (safety) and treatment efficacy.Main resultsOf the 1390 studies initially identified, 18 were assessed for eligibility. Of these, 3 studies (n = 464) fulfilled a priori criteria for inclusion; most studied children with moderate dehydration and none were conducted in resource-poor settings. Volumes and rates of fluid replacement varied from 20 to 60 ml/kg given over 1-2 h (fast) versus 2-4 h (slow). There was substantial heterogeneity in methodology between the studies with only one adjudicated to be of high quality. There were no deaths in any study. Safety endpoints only identified oedema (n = 6) and dysnatraemia (n = 2). Pooled analysis showed no significant difference between the rapid and slow intravenous rehydration groups for the proportion of treatment failures (N = 468): pooled RR 1.30 (95% CI: 0.87, 1.93) and the readmission rates (N = 439): pooled RR 1.39 (95% CI: 0.68, 2.85).ConclusionsDespite wide implementation of WHO Plan C guideline for severe AGE, we found no clinical evaluation in resource-limited settings, and only limited evaluation of the rate and volume of rehydration in other parts of the world. Recent concerns over aggressive fluid expansion warrants further research to inform guidelines on rates of intravenous rehydration therapy for severe AGE.Electronic supplementary materialThe online version of this article (10.1186/s12887-018-1006-1) contains supplementary material, which is available to authorized users.

show abstract

“…All the eligible RCTs [ 18 – 20 ] were identified through the database search. Two of the included studies [ 18 , 19 ] were conducted in resource-rich countries.…”

Section: Resultsmentioning

confidence: 99%

“…Canada and the USA respectively. While the third [ 20 ] was conducted in Iran. The characteristics of the included studies are summarised in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Rapid intravenous rehydration of children with acute gastroenteritis and dehydration: a systematic review and meta-analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

Understanding the use of oral rehydration therapy: A narrative review from clinical practice to main recommendations

Aghsaeifard

Heidari

Alizadeh

2022

Health Science Reports

View full text Add to dashboard Cite

Background and Aims Fluid loss due to diarrhea remains a significant cause of mortality among children under the age of 5. Methods Oral rehydration therapy (ORT) is a first‐line therapeutic measure to compensate the volume loss due to diarrhea and vomiting among gastroenteritis patients. Despite adequate knowledge, the practice of ORT is limited, particularly in developing countries. Results Several recommendations are provided regarding the use of ORT to treat hypovolemia, however, the information regarding its adequate usage is restricted within the healthcare centers and professionals. Conclusion This review highlights the importance of providing recommendations regarding the use of ORT. We also discuss the barriers and alternatives that might limit its use.

show abstract

Outcomes and predictors of early emergency department discharge among children with acute gastroenteritis and moderate dehydration

Almutairi

Al-Saleh

Qadrah

et al. 2022

International Journal of Pediatrics and Adolescent Medicine

View full text Add to dashboard Cite

Background: Gastroenteritis is one of the most common diseases that affects children and remains a leading cause of morbidity and mortality around the world. There is conflicting evidence regarding the effect of rapid intravenous fluid regimen on the clinical outcome of patients with acute gastroenteritis. This study aimed to assess the current practice of intravenous hydration on the clinical outcomes of pediatric patients with acute gastroenteritis and determine the predictive factors for early discharge and emergency department (ED) revisit. Methods: A cohort study was carried out among children aged from 1 month to 14 years who presented to the ED in a tertiary care hospital between September 2015 and September 2017. Children diagnosed with acute gastroenteritis and moderate dehydration who require intravenous hydration were included in the study. The patients were followed up until discharge from ED, admission to the hospital or revisit to the ED. Collected variables were demographics, presenting symptoms, biochemical marker, amount of intravenous fluid (IVF) received and prescription of anti-emetics. Descriptive statistics were summarized as mean, standard deviation for continuous variables and proportions for categorical variables. Logistic regression was used to identify risk factors. Results: Out of 284 patients, 148 (52%) were males, 20 (7%) were infants, 80 (28%) were toddlers, 90 (32%) were in preschool, 88 (31%) were in school and 6 (2.1%) were adolescents. No significant difference was observed in the admission rate, discharge within 12 h or less and ED revisits for those who received IVF >40 ml/kg as compared to those who received <40 ml/kg. Patients with bicarbonate level closer to normal are more likely to be discharged after 4 h (odds ratio (OR) 1.2 and 95% CI 1.12–1.43). Patients presenting only with vomiting/diarrhoea were less likely to revisit ED (OR 0.33 (95% CI 0.143 - 0.776), while patients with an increase in CO2 level (OR 1.19 and 95% CI 1.0 -1.436) and anion gap (OR 1.29 and 95% CI 1.08–1.54) were more likely to revisit within 1 week post discharge. Conclusion: This study did not show any additional benefits of receiving IVF > 40 ml/kg over 4 h neither in early discharge nor in reducing the ED revisit. CO2 closer to normal was a significant predictor for early discharge in 4 h where the closer level of CO2 and AGAP were associated with an increase in the chance of a revisit to the ED within 1 week after discharge.

show abstract

Rapid Intravenous Rehydration to Correct Dehydration and Resolve Vomiting in Children with Acute Gastroenteritis

Cited by 6 publications

References 11 publications

Rapid intravenous rehydration of children with acute gastroenteritis and dehydration: a systematic review and meta-analysis

Rapid intravenous rehydration of children with acute gastroenteritis and dehydration: a systematic review and meta-analysis

Understanding the use of oral rehydration therapy: A narrative review from clinical practice to main recommendations

Outcomes and predictors of early emergency department discharge among children with acute gastroenteritis and moderate dehydration

Contact Info

Product

Resources

About