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Oral Rehydration in Children with Acute Diarrhoea and Moderate Dehydration-Effectiveness of an ORS Tolerance Test

Rhondi Kauna1, Kone Sobi1, Wendy Pameh2

  • 1Department of Paediatrics, Port Moresby General Hospital, NCD, Papua New Guinea.

Journal of Tropical Pediatrics
|July 23, 2019
PubMed

Insights

An oral rehydration solution (ORS) tolerance test helps identify children with moderate dehydration who can be successfully managed at home, reducing unnecessary hospitalizations and intravenous fluid use.

Area of Science:

  • Pediatrics
  • Gastroenterology
  • Emergency Medicine

Background:

  • Oral rehydration solution (ORS) is crucial for treating acute watery diarrhea but is underutilized, leading to unnecessary hospitalizations.
  • Children with moderate dehydration often receive intravenous fluids instead of ORS, increasing healthcare costs and burden.

Purpose of the Study:

  • To evaluate the effectiveness of an ORS tolerance test in emergency departments.
  • To determine the ORS volume required for successful home management of children with moderate dehydration.

Main Methods:

  • 129 children with moderate dehydration received ORS in a Children's Emergency Department (CED) for 2-4 hours.
  • Discharge decisions were based on oral intake assessment and clinical judgment.
  • Patients were followed up on days 2 and 5 to assess treatment outcomes.

Main Results:

  • 61.2% (79/129) of children tolerated ORS well, drinking a median of 24.4 ml/kg.
  • Of those who tolerated ORS, 79.7% (63/79) improved with home treatment.
  • Children who failed home treatment had tolerated significantly less ORS (median 11.1 ml/kg) compared to those who succeeded (median 25.8 ml/kg).

Conclusions:

  • An ORS tolerance test is a valuable tool for identifying children with moderate dehydration suitable for home-based oral rehydration therapy.
  • Successful ORS tolerance in the emergency department predicts positive outcomes for home management.
  • Implementing ORS tolerance testing can reduce hospital admissions and intravenous fluid administration for pediatric diarrhea.

Keywords:
Papua New Guineadiarrhoea and dehydrationhome careoral rehydration solution

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