How to Predict Oral Rehydration Failure in Children With Gastroenteritis

OBJECTIVES:: Oral rehydration is the standard in most current guidelines for young children with acute gastroenteritis (AGE). Failure of oral rehydration can complicate the disease course, leading to morbidity due to severe dehydration. We aimed to identify prognostic factors of oral rehydration failure in children with AGE. METHODS:: Design A prospective, observational study.Setting Emergency department (ED), Erasmus Medical Centre, Rotterdam, The Netherlands, 2010- 2012.Patients 802 previously healthy children, aged 1 month-5 years with AGE.Outcome Failure of oral rehydration was defined by secondary rehydration by a nasogastric tube, or hospitalisation or revisit for dehydration within 72?hours after initial ED visit. RESULTS:: We observed 167 (21%) failures of oral rehydration in a population of 802 children with AGE (median 1.03 years old, IQR 0.4–2.1; 60% male). In multivariate logistic regression analysis, independent predictors for failure of oral rehydration were a higher Manchester Triage Urgency (MTS) level, abnormal capillary refill time (CRT) and a higher clinical dehydration scale (CDS) score. CONCLUSION:: Early recognition of young children with AGE at risk of failure of oral rehydration therapy is important, as emphasized by the 21% therapy failure in our population. Associated with oral rehydration failure are higher MTS urgency level, abnormal CRT and a higher CDS score.

• View at Publisher
• View at Scopus

Free Full Text ( Final Version , 358kb )