Evaluation of rehydration effectiveness and adverse effects in pediatric emergency room

Abstract

Introduction: Due to their physiology children are very prone to get dehydrated and that makes rehydration one of the most common procedures in Pediatric Emergency Room (PER). Various types of rehydration methods are availabe but their popularity, effectiveness, and caused adverse effects can be different. Aim: To evaluate the effectiveness and adverse effects of rehydraton (RH) in PER. Methods: Retrospective observational study involving 50 children treated with RH therapy in PER of Lithuanian University of Health Sciences Hospital Kaunas Clinics in July of 2018 was conducted. Statistical analysis of data was performed and variables were compared between RH methods and different levels of DH. Results: DH was documented for 23 patients, degree was assigned to 10: first degree (I°) n=1, first-second degree (I-II°) n=2, second degree (II°) n=7. Most common cause of DH was fever (58%). Oral rehydration (OR) was used for 2, intravenous rehydration (IR) for 49 patients with isotonic sodium chloride solution (ISS) as initial solution. “Standard“ solution (STS) was used as supporting treatment for 25 children. ISS infusion speed was higher for patients with documented DH (3,02 and 2,12 hourly fluid requirement (HFR), p<0,05) and differed among degrees of DH: I-II° 1,62 HFR, II° 3,87 HFR, p<0,05. Infusion of STS was slower for children with fever >37,8°C compared to patients who was not feverish (1,14 and 1,41 HFR, p<0,05). There were 10 hospitalised patients (20%) with no connection to RH. Observed complications: 1 accidental removal of catheter, 1 infiltration in the site of catheter, 11 cases of facial edema. Both solutions were used 81,8% of facial edema cases, p<0,05. Facial edema was associated with more voluminous RH with STS (611 and 500 ml, p<0,05), and faster infusion (speed of ISS 3,3 and 2,34 HFR, speed of STS 1,5 and 1,28 HFR, speed of boths solutions 2,1 ir 1,65 HFR p<0,05). OR failed for one patient.[...].