Because oral therapy can be started more quickly less painful and risky for the child than I.V. treatment, the researchers say it should be the preferred treatment for children with moderate dehydration.
The research, performed in the emergency department of The Children's Hospital of Philadelphia, supports previous recommendations by expert groups such as the American Association of Pediatrics and the World Health Organization.
"Currently, the majority of pediatric emergency physicians continue to use I.V. therapy for these children, both because they believe parents and referring physicians expect it, and because they believe oral therapy is time-consuming," said Philip Spandorfer, M.D., a pediatric emergency physician at The Children's Hospital of Philadelphia and primary researcher on the study.
A randomised controlled clinical trial was performed with 73 children between eight weeks and three years. 36 were randomised to receive oral rehydration therapy (ORT) and 37 were randomised to receive intravenous fluid therapy (IVF). Less than one third of the group that received ORT required hospitalisation, whereas almost half of the IVF group was hospitalised. Patients in the ORT group received small amounts of fluid (Pedialyte) over a period of four hours. After instruction, parents provided the fluid to their children.
Half of the participants in both groups were rehydrated successfully in four hours. The time required to start therapy was less in the ORT group, at just under 20 minutes compared to 41 minutes in the IVF group.
"By the end of the study, we realized that most families prefer to start with the oral rehydration therapy for treatment of moderate dehydration," said Dr. Spandorfer. "It is our hope that this study may support greater adoption of ORT by emergency physicians."
MEDICA.de; Source: Children's Hospital of Philadelphia