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Robert Listernick, MD; Edward Zieserl, MD; A Todd Davis, MD

Am J Dis Child. 1986;140(3):211-215.

Abstract
• 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.

(AJDC 1986;140:211-215)

Author Affiliations
From the Department of Pediatrics, Northwestern University Medical School, Chicago, and the Division of General and Emergency Pediatrics, The Children's Memorial Hospital, Chicago.

Footnotes
Accepted for publication Oct 29, 1985.

Presented in part at the Annual Meeting of the Ambulatory Pediatrics Association, Washington, DC, May 9, 1985.

Reprint requests to Division of General and Emergency Pediatrics, The Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614 (Dr Listernick).

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