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

Reid, Samuel; Bonadio, William A.

doi:10.1016/s0196-0644(96)70032-x

Cited by 68 publications

(41 citation statements)

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“…Reid and Bonadio found that statistical analysis, however, ''did not identify presenting characteristics that would distinguish patients who would require subsequent medical evaluation after rapid IV rehydration from those who would not.'' 25 Wathen et al found that children who had low serum glucose levels (<60 mmol/L) were more likely to have an unscheduled return visit but found no other defining characteristics of this population.…”

Section: Discussionmentioning

confidence: 92%

“…This is similar to the findings of Reid and Bonadio, who found that although patients with serum bicarbonate levels of <13 were less likely to tolerate oral fluids after rapid IV rehydration therapy, of those patients who were discharged, there was no difference in serum bicarbonate level between those who required further medical care and those who did not. 25 Similarly, Wathen et al found that although children with serum bicarbonate levels of %13 were more likely to undergo observation than were children with serum bicarbonate levels of >13, all patients who had unscheduled return visits had serum bicarbonate levels of >13.…”

Section: Discussionmentioning

confidence: 98%

“…20 Since then, other studies have had similar conclusions about the safety and efficacy of rapid IV rehydration. [21][22][23][24][25][26] Reid and Bonadio prospectively identified 58 patients with vomiting and dehydration and found that all demonstrated improvement in hydration status after rapid IV rehydration. 25 Similarly, Moineau and Newman described 17 patients, all of whom had vomiting before receiving rapid IV rehydration; all patients improved after therapy and only 6 of 17 had any vomiting after therapy.…”

Section: Discussionmentioning

confidence: 99%

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Intravenous Dextrose during Outpatient Rehydration in Pediatric Gastroenteritis

Levy

Bachur

2007

Acad Emergency Med

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Intravenous Dextrose during Outpatient Rehydration in Pediatric Gastroenteritis

Levy

Bachur

2007

Acad Emergency Med

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“…La rehidratación intravenosa rápida ha demostrado ser eficaz y segura en muchos países no desarrollados; por lo tanto, es la recomendada por la OMS para la rehidratación intravenosa de niños con deshidratación grave, con falla o contraindicación de la rehidratación oral (13,15,16). Ésta se desarrolla durante un periodo habitualmente menor de seis horas en niños mayores de un año.…”

Section: Discussionunclassified

“…En esa época se fortaleció el concepto de que lograr la rehidratación en el menor tiempo posible era ideal, dado que la rápida expansión del espacio extracelular permitía mejorar la perfusión renal y gastrointestinal, lo que se traducía en un rápido y efectivo retorno a la alimentación (4). Varias publicaciones posteriores han consolidado aún más la rehidratación oral y la intravenosa rápida como métodos efectivos y seguros para el tratamiento de los niños deshidratados (13)(14)(15)(16)(17)(18).…”

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Encuesta nacional sobre los conocimientos impartidos en escuelas de medicina de Colombia sobre rehidratación parenteral en niños eutróficos mayores de un año con deshidratación por enfermedad diarreicaIván

et al. 2011

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Introducción. Ante la deshidratación grave por diarrea y la contraindicación para rehidratación oral, la rehidratación en niños debe realizarse por vía intravenosa. La Organización Mundial de la Salud (OMS) recomienda la rehidratación rápida. Objetivos. Describir los métodos de rehidratación intravenosa enseñados en las escuelas de medicina colombianas y confrontarlos con las recomendaciones de la OMS. Materiales y métodos. Se elaboró una encuesta para docentes de pediatría en escuelas de medicina. Se hicieron preguntas directas y se detallaron casos clínicos de niños deshidratados para ser resueltos. Se preguntó por las indicaciones para la hidratación intravenosa y la forma de hacerla (volumen, solución, concentraciones y velocidad de infusión).Resultados. Se aplicaron 41 encuestas (82 % de escuelas). Se mencionaron las contraindicaciones inadecuadas para el tratamiento de rehidratación oral en 41 % de ellas. Se recomendó rehidratación intravenosa rápida en 71 %, lenta en 29 % Y con bolos en 57 %. Menos de la mitad de los encuestados recomendaron adecuadamente el volumen por infundir y, el 85 %, la concentración de sodio. En 56 % de las escuelas no se usa glucosa en las soluciones y en 65,9 % usan lactato de Ringer. También, se utilizan solución salina normal, dextrosa con electrolitos y solución polielectrolítica. Conclusiones. Existen ideas erróneas para contraindicar el tratamiento de la rehidratación oral. La tercera parte de las escuelas indican el tratamiento lento a pesar de la superioridad del rápido en la literatura. Falta uniformidad en los esquemas de tratamiento rápido. Es común la hidratación con bolos, sin sustento en la literatura científica. Es necesario actualizar los conceptos sobre hidratación en las escuelas de medicina y proponer una guía nacional para la rehidratación intravenosa.Palabras clave: fluidoterapia,soluciones para rehidratación, deshidratación, diarrea, Colombia. Intravenous rehydration for diarrheal dehydration of eutrophic children: survey of protocols provided at Colombian medical schoolsIntroduction. In all cases of severe dehydration from diarrhea, WHO recommends rapid rehydration. If oral rehydration in children is contraindicated, intravenous rehydration is recommended for immediate administration. However, methods of intravenous rehydration appear to be inadequately addressed in the medical schools of Colombia. Objective. Current approaches to oral rehydration were summarized, and instructors were informed concerning current WHO recommendations. Materials and methods. A survey was designed for pediatric instructors in Colombian medical schools. Direct questions about rehydration methods were included as well as presentation of theoretical clinical situations with dehydrated children. The survey also asked for the conditions necessary for intravenous rehydration and method of administration (volume, solution, concentration and speed of infusion).Results. Forty-one surveys were included (82% of medical schools in Colombia). Inadequate contraindications for oral rehydratio...

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How Commonly Are Children Hospitalized for Dehydration Eligible for Care in Alternative Settings?

McConnochie

Conners²,

Lu³

et al. 1999

Arch Pediatr Adolesc Med

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Background: Avoiding unnecessary hospitalization has long been a goal of child health care providers. Managed care practice environments increasingly pressure the practicing pediatrician to avoid hospitalization. Objectives: To estimate the proportion of childhood dehydration hospitalizations eligible for care in alternative settings (eg, short-stay treatment and triage units, home nursing) and to assess the type and duration of services that might be required for alternative setting care of children with these illness episodes. Design: All dehydration hospitalizations for the 198 593 children (aged Ͼ1 month and Ͻ19 years) dwelling in Rochester, NY (Monroe County), between 1991 and 1995 were identified in county-wide hospital discharge computer files. Medical records were reviewed for a random sample of 380 of the hospitalizations. Children with major underlying conditions were excluded from analysis because of higher risk for deterioration, and greater complexity of medical care might render alternative settings inappropriate. Measures included a 4-item score estimating level of dehydration, serum bicarbonate level at presentation, and time to rehydration. Rehydration was defined as a drop in urinespecific gravity to 1.010 or less or reduction of fluid administration to the maintenance rate. Results: Altogether, 1121 dehydration hospitalizations occurred during the study period. Based on medical record review for a random sample of 380 of these 1121, major underlying problems were present in 27.4% (104) of hospitalizations sampled. Simple, acute gastroenteritis accounted for 75.4% (208) of 276 hospitalizations remaining in the sample. Levels of dehydration for these children were estimated as at least 5% for 51.0% (106) and at least 10% for 16.3% (34) of hospital admissions, and serum bicarbonate levels were 12 mmol/L or less for 26.0% (54). Time from hospital admission to rehydration was no greater than 12 hours for 79.3% (165) and no greater than 24 hours for 94.7% (197). However, hospital stay was generally substantially longer. The time hospitalized following rehydration represented 85.8% of the average inpatient stay. Hospital discharge was heavily concentrated in daytime hours, although the children achieved rehydration at all hours of the day. No deterioration occurred during hospitalizations studied. Conclusion: Nearly all children hospitalized for simple, acute gastroenteritis in Rochester might be eligible for care in alternative settings designed to provide hospitallevel care for short periods.

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

Cited by 68 publications

References 4 publications

Intravenous Dextrose during Outpatient Rehydration in Pediatric Gastroenteritis

Intravenous Dextrose during Outpatient Rehydration in Pediatric Gastroenteritis

Encuesta nacional sobre los conocimientos impartidos en escuelas de medicina de Colombia sobre rehidratación parenteral en niños eutróficos mayores de un año con deshidratación por enfermedad diarreicaIván

How Commonly Are Children Hospitalized for Dehydration Eligible for Care in Alternative Settings?

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