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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
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.
Medline, CINAHL and EMbase were searched via NICE healthcare database advanced search using the following terms: (‘paediatric’ or …
Contributors DM devised the initial question, performed the initial literature search and wrote the first draft of the manuscript. CR and JR contributed revisions to the first draft. CR and DM contributed revisions to the second draft. DM completed the final drafts of this manuscript.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
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