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Changes in intravenous hydration frequency and emergency department length of stay after implementation of oral ondansetron therapy in children with dehydration due to acute gastroenteritis

Other Title
급성위장염 소아환자에서 ondansetron 경구요법 시행 후 정맥내 수액요법 빈도 및 응급실 체류시간의 변화
Authors
Kwon, SK; Yang, HW; Chae, MK; Ko, Y; Kwak, JR; Lee, JS
Citation
Pediatric Emergency Medicine Journal, 5(2):44-48, 2018
Journal Title
Pediatric Emergency Medicine Journal; 대한소아응급의학회지
ISSN
2383-48972508-5506
Abstract
PURPOSE: Oral ondansetron is a safe and effective antiemetic drug to facilitate oral rehydration therapy in acute gastroenteritis (AGE) with mild dehydration. We investigated the effect of oral ondansetron therapy on intravenous (IV) hydration frequency and emergency department length of stay (EDLOS) in dehydrated children with AGE.
METHODS: We reviewed 15,813 children aged 12-60 months with primary diagnosis of AGE who visited a tertiary care university-affiliated hospital emergency department. The enrolled children were divided into the pre- (from January 2009 to June 2011) and post- (from January 2016 to June 2018) ondansetron groups according to the implementation of oral ondansetron therapy in the emergency department. As primary outcomes, IV hydration frequency, EDLOS, and hospitalization rate were compared between the 2 groups. As secondary outcomes, EDLOS and hospitalization rate were compared between the children in the post-ondansetron group who underwent the therapy, and those who did not.
RESULTS: Of 7,990 enrolled children, 3,300 (41.3%) were designated as the post-ondansetron group, and among them 1,093 (33.1%) underwent oral ondansetron therapy. This group showed a lower IV hydration frequency, a shorter median EDLOS compared to the other group (61.9% vs. 55.8%, P < 0.001: 223.0 minutes vs. 175.0 minutes, P < 0.001, respectively), and a higher hospitalization rate (7.9% vs. 9.9%, P < 0.001). The children in the post-ondansetron group who underwent the therapy showed a shorter median EDLOS and a lower hospitalization rate compared to those who did not (142.0 vs 205.0 minutes, P < 0.001: 2.9% vs. 13.4%, P < 0.001, respectively).
CONCLUSION: Oral ondansetron therapy may reduce IV hydration frequency and EDLOS in dehydrated children with AGE, and can be considered in those having severe vomiting.
Keywords
DehydrationFluid TherapyGastroenteritisOndansetronPediatric Emergency Medicine
DOI
10.22470/pemj.2018.00269
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Emergency Medicine
AJOU Authors
양, 희원최, 민정고, 유라곽, 재령이, 지숙
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