Alternative Rehydration Methods: A Systematic Review and Lessons for Resource-Limited Care

Rouhani, Shada A.; Meloney, Laura; Ahn, Roy; Nelson, Brett D.; Burke, Thomas F.

doi:10.1542/peds.2010-0952

Cited by 39 publications

(23 citation statements)

References 35 publications

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“…The top 24 global EM articles for 2011 are listed in Table 3 2–25 . The complete database of all 206 global EM articles for 2011, as well as full summaries and critical analyses of the top 24 global EM of articles of 2011, can be found online as Data Supplements S1 and S2 (available as supporting information in the online version of this paper).…”

Section: Resultsmentioning

confidence: 99%

“…In Pakistan, a cluster‐randomized trial studied amoxicillin for community‐based treatment of pneumonia in young children and found that community health workers deliver treatment for severe pneumonia with more success than referral to the hospital 13 . Alternative rehydration methods, including nasogastric and intraosseous rehydration, were reviewed by Rouhani et al 21 and found to be efficacious as compared to intravenous hydration for moderate to severe dehydration in children with diarrhea. Two additional articles examined different antibiotic regimens for treatment of fever.…”

Section: Discussionmentioning

confidence: 99%

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Global Emergency Medicine: A Review of the Literature From 2011

Schroeder

Jacquet²,

Becker³

et al. 2012

Academic Emergency Medicine

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Objectives: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of published and unpublished articles relevant to global emergency medicine (EM) to identify, review, and disseminate the most important research in this field to a wide audience of academics and practitioners.Methods: This year, 7,924 articles written in seven languages were identified by our search. These articles were divided up among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the grey literature. A total of 206 articles were deemed appropriate by at least one reviewer and approved by their editor for formal scoring of their overall quality and importance.Results: Of the 206 articles that met our predetermined inclusion criteria, 24 articles received scores of 17 or higher and were selected for formal summary and critique. Interrater reliability for our scoring system was good with an interclass correlation coefficient of 0.628 (95% confidence interval = 0.51 to 0.72).Conclusions: Compared to previous reviews, there was a significant increase in the number of articles that were devoted to emergency care in resource-limited settings, with fewer articles related to disaster and humanitarian response. The majority of articles that met our selection criteria were reviews that examined the efficacy of particular treatment regimens for diseases that are primarily seen in low-and middle-income countries.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Global Emergency Medicine: A Review of the Literature From 2011

Schroeder

Jacquet²,

Becker³

et al. 2012

Academic Emergency Medicine

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“…Especially rHuPH20 was described as enabling a fivefold faster subcutaneous liquid absorption, which makes it therefore possible to adapt this technique for paediatrics [55,56,57]. Other authors are more critical of this application since data do not show explicit benefits compared to other rehydration techniques [58]. …”

Section: Therapeutic Use Of Haasementioning

confidence: 99%

Use of Hyaluronidase for Pharmacokinetic Increase in Bioavailability of Intracutaneously Applied Substances

Wohlrab¹,

Wohlrab

Wohlrab³

et al. 2014

Skin Pharmacol Physiol

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Endogenous hyaluronidases in the human body have physiological and pathophysiological significance due to their enzymatic activity during the cleavage of hyaluronan. The potential of therapeutic use of testicular and recombinant hyaluronidase has been increasingly acknowledged and developed in recent years. Most relevant in practice is the co-application of hyaluronidase and other active substances in order to enhance their bioavailability within the tissue.

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“…Nasogastric tubes have been shown to be equivalent to intravenous (IV) fluids for rehydrating children, even in moderate-to-severe dehydration (Green, 1987; Hidayat et al, 1988; Gremse, 1995; Nager & Wang, 2002; Yiu, Smith & Catto-Smith, 2003; Fonseca, Holdgate & Craig, 2004; Oakley et al, 2010; Rouhani et al, 2011; Freedman et al, 2015). Placement of NG tubes does not require advanced medical skills and can be employed by community health workers, nurses, or paramedics in various healthcare facilities to begin rehydration while preparing to send the child to a higher level of care.…”

Section: Introductionmentioning

confidence: 99%

Qualitative study of healthcare providers’ current practice patterns and barriers to successful rehydration for pediatric diarrheal illnesses in Kenya

House

Cheptinga

Rusyniak

et al. 2017

PeerJ

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BackgroundFor children worldwide, diarrhea is the second leading cause of death. These deaths are preventable by fluid resuscitation. Nasogastric tubes (NGs) have been shown to be equivalent to intravenous fluids for rehydration and recommended by the World Health Organization (WHO) for use in severe dehydration. Despite this, NGs are rarely used for rehydration in Kenya. Our objective was to evaluate clinicians’ adherence to rehydration guidelines and to identify barriers to the use of NGs for resuscitating dehydrated children.MethodsA case-based structured survey was administered to pediatric care providers in western Kenya to determine their choices for alternative rehydration therapies when oral rehydration and intravenous fluids fail. Providers then participated in a qualitative, semi-structured interview to identify barriers to using nasogastric tubes for rehydration. Analysis included manual, progressive coding of interview transcripts to identify emerging central themes.ResultsOf 44 participants, only four (9%) followed WHO guidelines that recommend quickly switching to NG for rehydration in their case responses. Participants identified that placing intravenous lines in dehydrated children is a challenge. However, when discussing NG use, many believed NGs are not effective for rehydration. Other participants’ concerns surrounded knowledge and training regarding guidelines as well as not having NGs available.DiscussionHealthcare providers in western Kenya do not report using NGs for rehydration in accordance with WHO guidelines for diarrheal illness with severe dehydration. Barriers to the use of NG tubes were lack of knowledge and availability. Education and implementation of guidelines using NG tubes for rehydration may improve outcomes of children suffering from diarrheal illness with severe dehydration.

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Alternative Rehydration Methods: A Systematic Review and Lessons for Resource-Limited Care

Cited by 39 publications

References 35 publications

Global Emergency Medicine: A Review of the Literature From 2011

Global Emergency Medicine: A Review of the Literature From 2011

Use of Hyaluronidase for Pharmacokinetic Increase in Bioavailability of Intracutaneously Applied Substances

Qualitative study of healthcare providers’ current practice patterns and barriers to successful rehydration for pediatric diarrheal illnesses in Kenya

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