Pediatric Emergency Medicine Journal (Dec 2018)

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

  • Soon Kwang Kwon,
  • Hee Won Yang,
  • Minjung Kathy Chae,
  • Yura Ko,
  • Jae Ryoung Kwak,
  • Ji Sook Lee

DOI
https://doi.org/10.22470/pemj.2018.00269
Journal volume & issue
Vol. 5, no. 2
pp. 44 – 48

Abstract

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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.

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