FROZEN ORAL HYDRATION AS AN ALTERNATIVE TO CONVENTIONAL ENTERAL FLUIDS

Background: Oral hydration therapy is effective in dehydration, but is often bypassed or may fail. Objective: To compare the tolerance (amou nt accepted minus amount vomited) of a frozen solution (FS) (Revital-I CE, PTS Labs, Deerfield, ill) with the conventional glucose electrolyt e solution (CS). Design: Prospective, controlled crossover trial. Sett ing: Pediatric emergency department. Participants: A convenience sampl e of 91 children with enteritis, 6 months to 13 years of age, with mil d to moderate dehydration. Intervention: Children were offered either FS or CS. Each group was offered 10 mL/kg of either product during a 9 0-minute trial period, in 3 equal aliquots, and was monitored for the quantities consumed and vomited. Complete treatment failures (absolute refusals) were crossed over to the alternate product and intake was r ecorded. Main Outcome Measures: Tolerance of the full 10 ml/kg of the original product offered and, for treatment failures, the percentage w ho tolerated the alternate product. Results: Of the patients who initi ally received FS, 23 (55%) tolerated the full amount offered, compared with 5 (11%) in the CS group (P<.001). Of the 57% who completely refu sed CS, after crossover, 20% tolerated the full amount of FS and 33% t olerated between 5 and 9 ml/kg of FS and were discharged from the hosp ital. The original treatment failures for FS (12%) were crossed over t o CS; none tolerated more than 5 mL/kg. Conclusions: Children with mil d or moderate dehydration are more likely to tolerate FS than CS. Conv entional solution failures crossed over to FS had a greater tolerance rate than the reverse.