Standard versus rapid nasogastric rehydration for gastroenteritis in children

January 01, 0001

Standard versus rapid nasogastric rehydration for gastroenteritis in children

These Australian researchers compared two rehydration regimens for children with acute viral gastroenteritisn using nasogastric tubes. They enrolled children 6 to 72 months old presenting to emergency departments (ED) with acute viral gastroenteritis and moderate dehydration (n=254). Patients were randomized to either standard nasogastric rehydration (SNR) that involved admission and rehydration over 24 hours vs. rapid nasogastric rehydration (RNR) over 4 hours in the ED.

The researchers found: "All patients made a full recovery without severe adverse events. The primary failure rates were similar for RNR (11.8%) and SNR (9.2%). Secondary treatment failure was more common in the SNR group (44%) than in the RNR group (30.3%). Discharge from the ED after RNR failed for 27 patients (22.7%), and another 9 (7.6%) were readmitted to the hospital within 24 hours."

The researchers concluded: "Primary treatment failure and clinical outcomes were similar for RNR and SNR. Although RNR generally reduced the need for hospitalization, discharge home from the ED failed for approximately one-fourth of the patients."

Rapid nasogastric rehydration was about as effective as standard therapy, but did result in almost 30% of patients either returning to the ED or being admitted.

For the full abstract, click here.

Pediatrics 128(4):e771-e778, October 2011 © 2011 American Academy of Pediatrics
Randomized Clinical Trial of Rapid Versus 24-Hour Rehydration for Children With Acute Gastroenteritis. Colin V. E. Powell, Stephen J. Priestley, Simon Young, Ralf G. Heine.

Category: D. Digestive. Keywords: gastroenteritis, dehydration, rehydration, nasogastric, pediatric, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 25 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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