Tactics of Rehydration Therapy in Children with Acute intestinal infection: implementation of Federal guidelines in Pediatric Practice

The leading method for correcting water and electrolyte imbalance in children with grade I–II dehydration is oral rehydration therapy (ORT).

The aim of the study was to minimize the volume of infusion therapy (IT) in children with acute intestinal infections (AII) in hospital settings.

Materials and Methods. The study included 899 children with AII. The main group (MG, n = 442) consisted of patients managed by the authors; the comparison group (CG, n = 457) included children observed by other physicians of the same department. In both groups, oral rehydration with glucose-saline solutions was performed for grade I–II dehydration: in the MG — with a hypo-osmolar solution (245 mOsm/L), in the CG — with a hyperosmolar solution (282 mOsm/L). When ORT was ineffective, IT was prescribed: in the MG — isotonic Sterofundin solution, or Ringer lactate or 0.9% sodium chloride solution if Sterofundin was unavailable; in the CG — glucose-saline solutions (Sterofundin G-5, Normofundin G-5).

Results. Every third case of AII in both groups was attributable to invasive intestinal infections: 31.0% (137/442) in the MG and 31.9% (146/457) in the CG. Patients with grade I–II dehydration predominated in both groups. In children with grade I dehydration in the MG, IT was completely avoided (100% of cases); in grade II dehydration, IT was avoided in 20% of cases. In the CG, every second patient with grade I dehydration received IT, and every fifth patient with grade II dehydration received IT. The duration of dehydration resolution and the severity of the condition, assessed by the number of days, did not differ significantly between the groups.

Conclusion. Fostering maternal adherence to ORT made it possible to reduce the frequency of IT use in children with AII by 3 times.

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