Albert H Park1, Helen Kim. 1. Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, 2160 S. 1st Avenue, Maywood, IL 60153, USA.
Abstract
OBJECTIVE: To determine the feasibility, safety and efficacy of intravenous home hydration for pediatric postoperative adenotonsillectomy patients. METHOD: Nonrandomized control trial of two groups of pediatric patients following adenotonsillectomy--one with (H) and one without postoperative home intravenous hydration (WH). SETTING: A tertiary care, university-based children's hospital. INTERVENTION: Administration of 25 cm3 kg-1 of Lactated Ringer's solution once a day for 3 days via an intravenous catheter. RESULTS: Three of 22 patients in the (WH) group and none of the 25 patients in the (H) group required an emergency room admission for dehydration. Difficulty swallowing and activity level were found to be statistically different based on chi2-analysis (P<0.05). The hydration group (H) had a greater swallowing difficulty score (1.4) compared with the nonhydration (WH) group (0.06). The (H) group had a lower activity score (0.2) compared with the (WH) group. Other parameters such as duration of pain, the severity of pain, days until oral feeds could be taken without difficulty, degree of dysphagia, degree of neck, throat, tongue and ear pain were not statistically different between the two groups based on chi2-analysis (P<0.05). There were no complications associated with intravenous hydration. CONCLUSION: Increased efficacy from intravenous hydration was not shown based on a number of parameters. Selected patients with a high likelihood to develop dehydration or medically intractable emesis may benefit from intravenous hydration and may avoid emergency room or hospital admission. Bolus infusions of 25 cm3 kg-1 of Lactated Ringer's solution by home care nursing can be implemented safely in pediatric patients.
OBJECTIVE: To determine the feasibility, safety and efficacy of intravenous home hydration for pediatric postoperative adenotonsillectomy patients. METHOD: Nonrandomized control trial of two groups of pediatric patients following adenotonsillectomy--one with (H) and one without postoperative home intravenous hydration (WH). SETTING: A tertiary care, university-based children's hospital. INTERVENTION: Administration of 25 cm3 kg-1 of Lactated Ringer's solution once a day for 3 days via an intravenous catheter. RESULTS: Three of 22 patients in the (WH) group and none of the 25 patients in the (H) group required an emergency room admission for dehydration. Difficulty swallowing and activity level were found to be statistically different based on chi2-analysis (P<0.05). The hydration group (H) had a greater swallowing difficulty score (1.4) compared with the nonhydration (WH) group (0.06). The (H) group had a lower activity score (0.2) compared with the (WH) group. Other parameters such as duration of pain, the severity of pain, days until oral feeds could be taken without difficulty, degree of dysphagia, degree of neck, throat, tongue and ear pain were not statistically different between the two groups based on chi2-analysis (P<0.05). There were no complications associated with intravenous hydration. CONCLUSION: Increased efficacy from intravenous hydration was not shown based on a number of parameters. Selected patients with a high likelihood to develop dehydration or medically intractable emesis may benefit from intravenous hydration and may avoid emergency room or hospital admission. Bolus infusions of 25 cm3 kg-1 of Lactated Ringer's solution by home care nursing can be implemented safely in pediatric patients.