Outpatient oral rehydration in the United States
R. Listernick, E. Zieserl and A. T. Davis
Twenty-nine dehydrated, well-nourished infants, who were 3 to 24 months of
age and had acute gastroenteritis, were enrolled in a prospective
randomized study that compared the safety, efficacy, and costs of oral vs
intravenous rehydration. The study was designed to assess the use of a
holding room in the emergency room for the outpatient rehydration of
dehydrated infants. The oral solution that was used contained 60 mEq/L of
sodium, 20 mEq/L of potassium, 50 mEq/L of chloride, 30 mEq/L of citrate,
20 g/L of glucose, and 5 g/L of fructose. Thirteen of 15 patients were
successfully rehydrated orally as outpatients; two patients, who were
subsequently discovered to have urinary tract infections, required
hospitalization due to persistent vomiting. Orally rehydrated outpatients
spent a mean of 10.7 hours in the holding room, as compared with
intravenously rehydrated inpatients, who were hospitalized for a mean of
103.2 hours. Outpatient oral rehydration therapy was significantly less
costly than inpatient intravenous therapy (+272.78 vs +2,299.50). Our
results indicate that oral rehydration is a safe and cost-effective means
of treating dehydrated children in an outpatient setting in the United
States. The use of a holding room for observation in the emergency room can
markedly decrease health care costs and unnecessary hospitalizations.
