Documento de recomendaciones sobre la rehidratación intravenosa rápida en gastroenteritis aguda

  1. Andrea Mora-Capín
  2. Rosario López-López
  3. Belén Guibert-Zafra
  4. María de Ceano-Vivas La Calle
  5. Raquel Porto-Abad
  6. Juan Carlos Molina-Cabañero
  7. Nuria Gilabert-Iriondo
  8. Clara Ferrero-García-Loygorri
  9. Cristina Montero-Valladares
  10. María Ángeles García-Herrero
Journal:
Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

ISSN: 1695-4033 1696-4608

Year of publication: 2022

Volume: 96

Issue: 6

Pages: 523-535

Type: Article

DOI: 10.1016/J.ANPEDI.2021.04.017 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

Abstract

Introduction The efficacy and safety of the rapid intravenous rehydration (RIR) guidelines in children affected by dehydration secondary to acute gastroenteritis is supported by current scientific evidence, but there is also great variability in its use in clinical practice. Objective To prepare a document with evidence-based recommendations about RIR in paediatric population. Methods The project was developed based on GRADE methodology, according to the following work schedule: Working Group training; creation of a catalogue of questions about research and definition of «relevant outcomes»; score and selection criteria for each item; bibliographic review; scientific evidence evaluation and synthesis (GRADE); review, discussion and creation of recommendations. 10 clinical questions and 15 relevant outcomes were created (7 about efficacy and 8 about security). Results Sixteen recommendations were set up, from which we can highlight as the main ones: (1) RIR is safe for children affected by mild-moderate dehydration secondary to acute gastroenteritis, unless expressly contraindicated or acute severe comorbidity (strong recommendation and moderate evidence). (2) Its use is recommended in this situation when oral rehydration has failed or due to contraindication (strong and high). (3) Isotonic fluids are recommended (strong and high), suggesting saline fluid as the first option (light and low), supplemented by glucose (2.5%) in those patients showing normoglycemia and ketosis (strong and moderate). (4) A rhythm of 20 cc/kg/h is recommended (strong and high) during 1–4 h (strong and moderate). Conclusions This document establishes consensus recommendations, based on the available scientific evidence, which could contribute to the standardisation of the use of RIR in our setting