title: Nasogastric vs. intravenous rehydration in children with gastroenteritis and refusal to drink: a randomized controlled trial.
abstract: BACKGROUND
  Nasogastric rehydration therapy (NGRT) is the recommended therapy in moderately dehydrated children with gastroenteritis and refusal to drink, since it is supposed to be as effective if not better than intravenous rehydration therapy (IVRT). However, in clinical practice IVRT is often favored. We conducted a clinical trial to determine whether IVRT is not inferior to NGRT.
  
  
  METHODS
  Children 3 months to 6 years of age with moderate dehydration and refusal to drink secondary to gastroenteritis were recruited. After clinical assessment of the degree of dehydration, patients were assigned randomly to receive either IVRT or NGRT over 6 h on the hospital ward.
  
  
  RESULTS
  Recruitment did not yield the estimated number of patients. Mainly, non-enrollment was due to failure to obtain parental consent because IVRT was expected. 97 patients were enrolled in the study, 46 were randomized to NGRT and 51 to IVRT. There was no difference between IVRT and NGRT groups concerning length of hospital stay (2.2±1.1 days vs. 2.4±1.1 days), success of rehydration (78 vs. 76%) and adverse events.
  
  
  CONCLUSIONS
  Since we had to terminate the study ahead of schedule due to a low recruiting rate, our results are not reliable. However, data from the literature shows that the widespread described superiority of NGRT over IVRT is seriously influenced by studies from developing countries questioning the applicability of the results to a setting available in high-income countries nowadays.
  
  
  CONCLUSIONS
  Our study demonstrates the difficulties performing such a study in a high-income country to come to an objective and clearly evident final conclusion.
authors.affiliation: Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children's Hospital Duesseldorf, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Marquard
authors.affiliation: Department of General Practice, Cochrane Metabolic and Endocrine Disorders Group, Medical Faculty, University Hospital Duesseldorf, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Lerch
authors.affiliation: Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children's Hospital Duesseldorf, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Rosen
authors.affiliation: Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children's Hospital Duesseldorf, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Wieczorek
authors.affiliation: Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children's Hospital Duesseldorf, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Mayatepek
authors.affiliation: Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children's Hospital Duesseldorf, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Meißner
mesh_terms: D015982:Bias; D002648:Child; D002675:Child, Preschool; D003681:Dehydration / Q000628:therapy*; D004327:Drinking Behavior; D057239:Early Termination of Clinical Trials; D005260:Female; D005440:Fluid Therapy / Q000379:methods* / Q000706:statistics & numerical data; D005759:Gastroenteritis / Q000628:therapy*; D005858:Germany; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous / Q000706:statistics & numerical data; D007441:Intubation, Gastrointestinal / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D012107:Research Design / Q000706:statistics & numerical data