In children with gastroenteritis and a moderate dehydration clinic, the best treatment results are obtained with oral rehydration (ORT) compared to intravenous administration, as shown by the results of a published randomized study in the journal Pediatrics.

Oral rehydration therapy is recommended as "first line therapy" for mild and moderate dehydration in children. However, three-quarters of emergency pediatricians linked to the ORT recommendations of the American Academy of Pediatrics continue to use intravenous infusion therapy (HIT) to treat moderate dehydration in children.

The main hypothesis of the study was that the frequency of ineffectiveness ORT does not exceed by more than 5% the frequency of ineffectiveness HIT. The secondary hypothesis was that for patients receiving an ORD, less time is spent at the start of treatment, their positive dynamics are more pronounced after 2 hours of treatment and the need for additional hospitalization is reduced.

This study lasted from December 2001 to April 2003. in the emergency department of the municipal children's hospital. The inclusion criteria for children were 8 weeks to 3 years of age and moderate dehydration (score on a validated 10-point scale) due to viral gastroenteritis. The treating physicians examined the patients before randomization and after 2 and 4 hours of treatment.

Of the 73 patients included in this four-hour study, 36 patients were randomized to receive ORT and 37 for HIT. The groups did not differ in the initial assessment of the severity of dehydration and the number of previous episodes of vomiting and diarrhea. When evaluating the main variable, the ORT was "not worse". Its advantages have also been demonstrated in the analysis of secondary variables.

In half of the patients in both groups, treatment after 4 hours was considered effective, which was determined by stopping the symptoms of dehydration, restoring urine production, achieving an increase in body weight and stopping severe vomiting. The mean time after randomization required to start rehydration was 19.9 min for ORT and 41.2 min for HIT (the difference was 21.2 min).

After 2 hours, there was no difference between the groups to improve the patient's condition with a dehydration score (ORT 78.8% and HIT 80%, the difference was 1.2%). Hospitalization was required in less than a third of ORT patients and almost half of HIT patients (30.6 and 48.7, the difference was 18.1%).

This study demonstrated that oral rehydration therapy is as effective as intravenous infusion therapy for rehydration in children with moderate dehydration due to gastroenteritis.