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Effectiveness of nasogastric rehydration in hospitalized children with acute diarrhea
1Division of Pediatric Gastroenterology and Nutrition, University of South Alabama College of Medicine, Mobile, USA.
Insights
Nasogastric rehydration using oral rehydration solution is a safe and effective alternative to intravenous rehydration for infants hospitalized with mild to moderate dehydration, reducing hospitalization duration and costs.
Area of Science:
- Pediatrics
- Gastroenterology
Background:
- The American Academy of Pediatrics advocates for oral rehydration and early refeeding in infants with diarrhea and mild to moderate dehydration.
- Intravenous rehydration remains a common practice for hospitalized infants experiencing dehydration.
Purpose of the Study:
- To compare the efficacy and outcomes of intravenous rehydration versus nasogastric rehydration in hospitalized infants with mild to moderate dehydration.
Main Methods:
- Infants hospitalized for dehydration due to acute diarrheal illness who failed oral rehydration attempts were randomized to receive either intravenous or nasogastric rehydration.
- Following rehydration, all infants received soy formula and maintenance oral electrolyte solution.
- Study endpoints included successful rehydration, duration of hospitalization, and cost of care.
Main Results:
- Rehydration success rates were high in both groups (11/12 for nasogastric, 12/12 for intravenous).
- The degree of dehydration, vomiting, diarrhea severity, and rehydration duration were comparable between groups.
- Nasogastric rehydration resulted in shorter hospitalization duration and lower costs compared to intravenous rehydration.
Conclusions:
- Infusion of oral rehydration solution via a nasogastric tube is a safe and effective inpatient treatment for infants with mild to moderate dehydration.
- Nasogastric rehydration should be considered as a viable alternative to intravenous rehydration for hospitalized infants with diarrhea-associated dehydration.
Abstract:
The American Academy of Pediatrics recommends oral rehydration and early refeeding for management of infants with diarrhea and mild to moderate dehydration. However, intravenous rehydration is still widely used for treatment of infants hospitalized for dehydration. The administration of oral rehydration solution via continuous infusion through a nasogastric tube facilitates its delivery in hospitalized children. The purpose of this study is to compare intravenous and nasogastric rehydration in children hospitalized for mild to moderate dehydration. Infants who failed attempts at oral rehydration and were hospitalized for dehydration due to acute diarrheal illness were randomized to receive intravenous or nasogastric rehydration. Following rehydration, infants received soy formula and a maintenance oral electrolyte solution to replace ongoing stool losses, as directed by the attending physician. Patients were discharged from the hospital once oral feeding was tolerated, and the vomiting and diarrhea resolved. Twenty-four patients, from 2 to 19 months of age, were enrolled in the study. Rehydration was successful in 11 of 12 patients in the nasogastric rehydration group and in all 12 patients who received intravenous rehydration. The degree of dehydration, severity of vomiting and diarrhea, and duration of rehydration were similar in both groups. The duration and cost of hospitalization were less for patients receiving nasogastric rehydration compared to those who were rehydrated intravenously. Rehydration by infusion of oral rehydration solution via a nasogastric tube is a safe and effective treatment for infants with mild to moderate dehydration. Rehydration with infusion of oral rehydration solution through a nasogastric tube should be considered for in-patient management of infants with diarrhea.