title: Randomized clinical trial of rapid versus 24-hour rehydration for children with acute gastroenteritis.
abstract: OBJECTIVE
  To compare the efficacy of 2 nasogastric rehydration regimens for children with acute viral gastroenteritis.
  
  
  METHODS
  Children 6 to 72 months of age with acute viral gastroenteritis and moderate dehydration were recruited from emergency departments (EDs) at 2 metropolitan, pediatric, teaching hospitals. After clinical assessment of the degree of dehydration, patients were assigned randomly to receive either standard nasogastric rehydration (SNR) over 24 hours in the hospital ward or rapid nasogastric rehydration (RNR) over 4 hours in the ED. Primary (>2% weight loss, compared with the admission weight) and secondary treatment failures were assessed.
  
  
  RESULTS
  Of 9331 children with acute gastroenteritis who were screened, 254 children were assigned randomly to receive either RNR (n = 132 [52.0%]) or SNR (n = 122 [48.0%]). Baseline characteristics for the 2 groups were similar. All patients made a full recovery without severe adverse events. The primary failure rates were similar for RNR (11.8% [95% confidence interval [CI]: 6.0%-17.6%]) and SNR (9.2% [95% CI: 3.7%-14.7%]; P = .52). Secondary treatment failure was more common in the SNR group (44% [95% CI: 34.6%-53.4%]) than in the RNR group (30.3% [95% CI: 22.5%-38.8%]; P = .03). Discharge from the ED after RNR failed for 27 patients (22.7%), and another 9 (7.6%) were readmitted to the hospital within 24 hours.
  
  
  CONCLUSIONS
  Primary treatment failure and clinical outcomes were similar for RNR and SNR. Although RNR generally reduced the need for hospitalization, discharge home from the ED failed for approximately one-fourth of the patients.
authors.affiliation: Departments of aEmergency Medicine, Royal Children’s Hospital, Melbourne, Australia.
authors.forename: Colin V E
authors.initials: CV
authors.lastname: Powell
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Priestley
authors.forename: Simon
authors.initials: S
authors.lastname: Young
authors.forename: Ralf G
authors.initials: RG
authors.lastname: Heine
mesh_terms: D000208:Acute Disease; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003681:Dehydration / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005759:Gastroenteritis / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D006801:Humans; D007223:Infant; D007441:Intubation, Gastrointestinal; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome