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Oral Rehydration
In Pediatrics, Less Is Often Better
Arch Pediatr Adolesc Med. 2004;158:420-421.
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Elsewhere in this issue of the ARCHIVES, Fonseca and colleagues1 compare enteral vs parenteral rehydration for children with gastroenteritis. The results of their meta-analysis indicate not only that intravenous rehydration is no more efficacious than fluids given orally or via a nasogastric tube but that intravenous rehydration is associated with longer hospitalization and a 3-fold increase in major adverse events. The study and the major findings are worthy of comment on a number of levels.
First it is important to critically assess the study design and interpretation of the results. The authors were rigorous in the conduct of their meta-analysis. The systematic evaluations of possible studies for inclusion and methodologies for uncovering all relevant trials seem complete. The main study outcomes (major adverse events defined by Fonseca et al as seizures or death, length of hospitalization, duration and severity of diarrhea following initiation of therapy, weight gain, and failure rate . . . [Full Text of this Article]
James A. Taylor, MD
Child Health Institute
Box 354920
Seattle, WA 98195
(e-mail: uncjat@u.washington.edu)
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RELATED ARTICLE
Enteral vs Intravenous Rehydration Therapy for Children With Gastroenteritis: A Meta-analysis of Randomized Controlled Trials
Bob K. Fonseca, Anna Holdgate, and Jonathan C. Craig
Arch Pediatr Adolesc Med. 2004;158(5):483-490.
ABSTRACT
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Enteral Rehydration Is the Best Way to Rehydrate Children with Gastroenteritis
JWatch General 2004;2004:3-3.
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