Assessment of Dehydration and Oral Rehydration Therapy for Pediatric Patients with Dehydration: A Review of Clinical Effectiveness, Clinical Utility, and Guidelines

Key Message

Two guidelines recommend oral rehydration therapy for mild to moderated dehydration in pediatric patients (strong recommendation, moderate to high level evidence). One guideline also recommends use of antiemetic agents such as ondansetron to facilitate tolerance of oral rehydration therapy in children (older than four years) and adolescents with acute gastroenteritis associated with vomiting (weak recommendation, moderate level evidence). One systematic review of 15 guidelines reported that the guidelines recommend oral rehydration therapy as first-line treatment in pediatric patients with acute gastroenteritis and moderate dehydration (strength of recommendation: not reported, level of evidence mostly moderate).This systematic review also reported that the guidelines recommend assessment of dehydration based on signs and symptoms (strength of recommendation not reported; level of evidence low or not reported), and a few of these guidelines recommend use of scoring systems.

Findings need to be interpreted in the light of limitations such as sparse reporting of methodological details and evidence supporting the recommendations. 

No relevant evidence on the comparative clinical utility of diagnostic tools for assessing dehydration was identified, therefore a summary cannot be provided.

No relevant evidence on the comparative clinical effectiveness of methods of administration of oral rehydration therapy in pediatric patients was identified.