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Karen A. Santucci, MD; Angela C. Anderson, MD; William J. Lewander, MD; James G. Linakis, MD, PhD

Arch Pediatr Adolesc Med. 1998;152:142-146.

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 to 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 refusals) 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.

From the Department of Pediatric Emergency Medicine, Rhode Island Hospital, Providence.

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