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QUESTION 1: Are subcutaneous fluids a viable alternative to intravenous therapy in rehydrating children with gastroenteritis and moderate dehydration?
  1. Dilshad Marikar,
  2. Carly Reynolds,
  3. Jerina Rich
  1. Luton and Dunstable Hospital NHS Foundation Trust, Luton, Bedfordshire, UK
  1. Correspondence to Dr Dilshad Marikar, Luton and Dunstable Hospital NHS Foundation Trust, Lewsey Road, Luton, Bedfordshire LU4 0DZ, UK; dilshad.marikar{at}nhs.net

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Scenario

You see an 18-month-old boy with diarrhoea and persistent vomiting, and diagnose gastroenteritis. There is clinical evidence of moderate dehydration. He has unfortunately not been able to tolerate oral rehydration therapy (ORT) in the department, and attempts to place a nasogastric tube to deliver ORT are met with stiff resistance. Cannulation for intravenous therapy is rather difficult, and mother and child look at you balefully as your team succeed on the third attempt. You have heard of subcutaneous fluids being used to successfully to rehydrate adults in your hospital—and wonder whether this technique could be used in children like your patient.

Structured clinical question

In children with gastroenteritis with moderate dehydration, and who cannot tolerate oral rehydration (Patient), can subcutaneous fluid rehydration (Intervention) be used in place of intravenous fluids (Comparison) to achieve effective rehydration (Outcome)?

Search strategy and outcome

Secondary sources

National Institute of Health and Care Excellence (NICE) evidence search identified the NICE guideline on diarrhoea and vomiting in children; however, no specific guidance on subcutaneous fluids is provided in it.

The Cochrane Library and BestBETs showed no relevant results.

Primary search

Medline, CINAHL and EMbase were searched via NICE healthcare database advanced search using the following terms: (‘paediatric’ or …

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