Levy, Jason A, Richard G Bachur, Michael C Monuteaux, and Mark Waltzman. “Intravenous Dextrose for Children with Gastroenteritis and Dehydration: a Double-Blind Randomized Controlled Trial..” Annals of Emergency Medicine. PMID 22959318
- RCT of kids with relatively severe gastro (nearly half got admitted)
- randomised to either initial 20ml/kg saline or D5NS
- fluid use beyond that was up to the doc
- everyone got blinded ketone and sugars taken by the researchers; though they don’t mention how often they got unblinded BSLs as part of usual care which may confuse things
- outcomes were rate of admission (which is a surrogate for what the kid looked like as that’s what usually determines admission)
- n = 188
- 44% admitted in saline group, 35% in D5NS group (non-sig)
- half of kids got glucose at some point of their care
- it improved the ketones
- i imagine they’re a fairly glucose heavy institution given that they were studying this which might not be immediately comparable to most places
- 20% of kids were hypoglycemic at initial BSL suggesting that any benefit here might be down to simply treating hypos – if the kids hypo he’s gonna look a bit shitty – it doesn’t mean much beyond symptomatic care but still nice to know.
Just as a reminder – we know that ORS needs glucose to allow the gut to absorb fluid and electrolytes though when you’re giving fluids IV you should be able to avoid this.