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Frozen oral hydration as an alternative to conventional enteral fluids
K A Santucci1, A C Anderson, W J Lewander
1Department of Pediatric Emergency Medicine, Rhode Island Hospital, Providence, USA.
Background:
Oral hydration therapy is effective in dehydration, but is often bypassed or may fail.
Objective:
To compare the tolerance (amount accepted minus amount vomited) of a frozen solution (FS) (Revital-ICE, PTS Labs, Deerfield, Ill) with the conventional glucose electrolyte solution (CS).
Design:
Prospective, controlled crossover trial.
Setting:
Pediatric emergency department.
Participants:
A convenience sample of 91 children with enteritis, 6 months to 13 years of age, with mild or moderate dehydration.
Intervention:
Children were offered either FS or CS. Each group was offered 10 mL/kg of either product during a 90-minute trial period, in 3 equal aliquots, and was monitored for the quantities consumed and vomited. Complete treatment failures (absolute refusal) were crossed over to the alternate product and intake was recorded.
Main Outcome Measures:
Tolerance of the full 10 mL/kg of the original product offered and, for treatment failures, the percentage who tolerated the alternate product.
Results:
Of the patients who initially received FS, 23 (55%) tolerated the full amount offered, compared with 5 (11%) in the CS group (P < .001). Of the 57% who completely refused CS, after crossover, 20% tolerated the full amount of FS and 33% tolerated between 5 and 9 mL/kg of FS and were discharged from the hospital. The original treatment failures for FS (12%) were crossed over to CS; none tolerated more than 5 mL/kg
Conclusions:
Children with mild or moderate dehydration are more likely to tolerate FS than CS. Conventional solution failures crossed over to FS had a greater tolerance rate than the reverse.