title: What do Clinicians Perceive as a Successful "Trial of Fluids"?: A Secondary Assessment of a Randomized Controlled Trial.
abstract: OBJECTIVE
  The aim of the study was to explore physician perceptions of the amount of fluid that demonstrates a successful "trial of fluids" (adequate fluid intake) in the emergency department in children who have had insufficient fluid intake at home.
  
  
  METHODS
  This is a secondary analysis of a randomized placebo-controlled trial of viscous lidocaine versus placebo in children aged 6 months to 8 years with acute infectious ulcerative mouth conditions (gingivostomatitis, ulcerative pharyngitis, or hand foot and mouth disease) and poor oral fluid intake. We measured the amount of fluid ingested in 60 minutes after administration of the intervention and related physician perception of adequate intake to measured intake. Given that there was little difference in oral intake between the treatment groups, the 2 arms were pooled for this analysis.
  
  
  RESULTS
  One hundred participants were recruited (50 per treatment group), all of whom completed the 60-minute trial period. At baseline, 72% were mildly dehydrated, 21% were not dehydrated, and 5% were moderately dehydrated. The participants drank a median of 8.6 mL/kg (interquartile range [IQR], 3.7-14). Clinicians perceived 58% of the participants to have an adequate intake within the first hour after intervention. The median consumption of those whose oral intake was deemed as adequate was 12.6 mL/kg (IQR, 9.4-18.4); for those whose oral intake was not deemed adequate, the median consumption was 2.7 mL/kg (IQR, 0.7-5.3) (rank sum, P < 0.001).
  
  
  CONCLUSIONS
  In children undergoing trial of fluids, we found that most clinicians perceived a fluid intake greater than 9 mL/kg as adequate and lower than 5 mL/kg as inadequate.
authors.affiliation: From the *Department of Emergency Medicine, Royal Children's Hospital; †Murdoch Children's Research Institute; ‡Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne; and §Junior Medical Staff Department, St Vincent's Hospital, Victoria, Australia.
authors.forename: Sandy M
authors.initials: SM
authors.lastname: Hopper
authors.forename: Michelle
authors.initials: M
authors.lastname: McCarthy
authors.forename: Chasari
authors.initials: C
authors.lastname: Tancharoen
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Lee
authors.forename: Francesca
authors.initials: F
authors.lastname: Orsini
authors.forename: Franz E
authors.initials: FE
authors.lastname: Babl
mesh_terms: D002648:Child; D002675:Child, Preschool; D003681:Dehydration / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy; D006232:Hand, Foot and Mouth Disease / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D010465:Perception; D010612:Pharyngitis / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D010820:Physicians / Q000523:psychology*; D013283:Stomatitis, Herpetic / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D008012:Lidocaine