title: Effects of Rapid Intravenous Rehydration in Children With Mild-to-Moderate Dehydration.
abstract: BACKGROUND
  New guidelines for "rapid or ultrarapid" intravenous rehydration are being developed in different emergency departments. These new guidelines propose a faster administration of fluids and electrolytes than in traditional protocols. However, there is still insufficient evidence to establish a standard protocol.
  
  
  OBJECTIVE
  Our objective was to determine the effects of an outpatient rapid intravenous rehydration regimen based on the administration of 0.9% saline + 2.5% dextrose, at a rate of 20 mL/kg per hour for 2 hours, in children with mild-to-moderate isonatremic dehydration resulting from acute gastroenteritis.
  
  
  METHODS
  We performed a 2-institution, prospective, observational, descriptive study. Eighty-three patients were included in the study. All patients underwent a first evaluation, including physical examination, laboratory tests, and assessment of clinical degree of dehydration. After this initial evaluation, all children received our intravenous rehydration regimen. A second evaluation including the same items as in the first one was made after in all the children.
  
  
  RESULTS
  Intravenous rehydration was successful in 69 patients (83.1%). It failed in 14 patients (16.8%), who required hospitalization because of persistent vomiting in 9 patients and poor general appearance in 5 patients. After intravenous rehydration, we observed a statistically significant decrease in the levels of ketonemia and uremia and in the Gorelick scale score. However, no significant changes were observed in sodium, chloride, potassium, and osmolarity values.
  
  
  CONCLUSIONS
  We conclude that, in children with mild-to-moderate dehydration, the administration of 20 mL/kg per hour for 2 hours of 0.9% saline solution + 2.5% glucose improved clinical scores and may be used as an alternative and safe way for intravenous rehydration.
authors.affiliation: From the *Department of Pediatrics, Hospital General Universitario Gregorio Marañón; and †Department of Emergency Pediatrics, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.
authors.forename: Sophie
authors.initials: S
authors.lastname: Janet
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Molina
authors.forename: Rafael
authors.initials: R
authors.lastname: Marañón
authors.forename: Marta
authors.initials: M
authors.lastname: García-Ros
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003681:Dehydration / Q000209:etiology / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005759:Gastroenteritis / Q000150:complications; D005947:Glucose / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D010045:Outpatients; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D012965:Sodium Chloride; D005947:Glucose