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Intravenous dextrose for children with gastroenteritis and dehydration: a double-blind randomized controlled trial.
Levy, Jason A; Bachur, Richard G; Monuteaux, Michael C; Waltzman, Mark.
Afiliação
  • Levy JA; Division of Emergency Medicine, Children's Hospital Boston, Harvard Medical School, Department of Pediatrics, Boston, MA, USA. jason.levy@childrens.harvard.edu
Ann Emerg Med ; 61(3): 281-8, 2013 Mar.
Article em En | MEDLINE | ID: mdl-22959318
STUDY OBJECTIVE: We seek to determine whether an initial intravenous bolus of 5% dextrose in normal saline solution compared with normal saline solution will lead to a lower proportion of hospitalized patients and a greater reduction in serum ketone levels in children with gastroenteritis and dehydration. METHODS: We enrolled children aged 6 months to 6 years in a double-blind, randomized controlled trial of patients presenting to a pediatric emergency department. Subjects were randomized to receive a 20 mL/kg infusion of either 5% dextrose in normal saline solution or normal saline solution. Serum ketone levels were measured before and at 1- and 2-hour intervals after the initial study fluid bolus administration. Primary outcome was the proportion of children hospitalized. Secondary outcome was change in serum ketone levels over time. RESULTS: One hundred eighty-eight children were enrolled. The proportion of children hospitalized did not differ between groups (35% in the 5% dextrose in normal saline solution group versus 44% in the normal saline solution group; risk difference 9%; 95% confidence interval [CI] -5% to 22%). Compared with children who received normal saline solution, those who received 5% dextrose in normal saline solution had a greater reduction in mean serum ketone levels at both 1 hour (mean Δ 1.2 versus 0.1 mmol/L; mean difference 1.1 mmol/L; 95% CI 0.4 to 1.9 mmol/L) and 2 hours (mean Δ 1.9 versus 0.3 mmol/L; mean difference 1.6 mmol/L; 95% CI 0.9 to 2.3 mmol/L). CONCLUSION: Administration of a dextrose-containing bolus compared with normal saline did not lead to a lower rate of hospitalization for children with gastroenteritis and dehydration. There was, however, a greater reduction in serum ketone levels in patients who received 5% dextrose in normal saline solution.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Desidratação / Hidratação / Gastroenterite / Glucose Tipo de estudo: Clinical_trials / Etiology_studies Limite: Child, preschool / Humans / Infant Idioma: En Ano de publicação: 2013 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Desidratação / Hidratação / Gastroenterite / Glucose Tipo de estudo: Clinical_trials / Etiology_studies Limite: Child, preschool / Humans / Infant Idioma: En Ano de publicação: 2013 Tipo de documento: Article