Beatrice C Canziani1, Peter Uestuener1, Emilio F Fossali1, Sebastiano A G Lava2,3,4, Mario G Bianchetti5,6, Carlo Agostoni1, Gregorio P Milani7,8. 1. Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. 2. University Children's Hospital, Inselspital, Bern, Switzerland. 3. University of Bern, Bern, Switzerland. 4. Division of Clinical Pharmacology and Toxicology, Ente Ospedaliero Cantonale, Institute of Pharmacological Sciences of Southern Switzerland, Lugano, Switzerland. 5. Pediatric Department of Southern Switzerland, 6500, Bellinzona, Switzerland. 6. Università della Svizzera Italiana, 6900, Lugano, Switzerland. 7. Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. milani.gregoriop@gmail.com. 8. Pediatric unit, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via della Commenda 9, 20122, Milan, Italy. milani.gregoriop@gmail.com.
Abstract
Currently recommended management of acute gastroenteritis is supportive. Although the affected children habitually have vomiting, recommendations do not focus on the correction of this symptom. In this condition, elevated ketone bodies and stimuli initiated by gut mucosa damage produced by the enteral pathogen likely underlay nausea and vomiting. As compared to 0.9% saline, intravenous administration of a dextrose-containing bolus of 0.9% saline is associated with a greater reduction of circulating ketones and a shorter duration of nausea and vomiting. Nonetheless, this treatment strategy is not followed by a lower rate of hospitalization. CONCLUSION: Well-designed investigations suggest that antagonists of the type 3 serotonin receptor, most frequently oral ondansetron, reduce the rate of vomiting, improve the tolerance of oral rehydration, and reduce the need for intravenous rehydration. What is Known: • Although children with gastroenteritis habitually have vomiting, current recommendations do not focus on the correction of this symptom. What is New: • Recently acquired evidence supports the prescription of ondansetron, an antagonist of the type 3 serotonin receptor, to increase the success rate of oral rehydration therapy.
Currently recommended management of acute gastroenteritis is supportive. Although the affected children habitually have vomiting, recommendations do not focus on the correction of this symptom. In this condition, elevated ketone bodies and stimuli initiated by gut mucosa damage produced by the enteral pathogen likely underlay nausea and vomiting. As compared to 0.9% saline, intravenous administration of a dextrose-containing bolus of 0.9% saline is associated with a greater reduction of circulating ketones and a shorter duration of nausea and vomiting. Nonetheless, this treatment strategy is not followed by a lower rate of hospitalization. CONCLUSION: Well-designed investigations suggest that antagonists of the type 3 serotonin receptor, most frequently oral ondansetron, reduce the rate of vomiting, improve the tolerance of oral rehydration, and reduce the need for intravenous rehydration. What is Known: • Although children with gastroenteritis habitually have vomiting, current recommendations do not focus on the correction of this symptom. What is New: • Recently acquired evidence supports the prescription of ondansetron, an antagonist of the type 3 serotonin receptor, to increase the success rate of oral rehydration therapy.
Entities:
Keywords:
Acute gastroenteritis; Antagonists of the type 3 serotonin receptor; Ketosis; Ondansetron; Vomiting
Authors: Alessandra Ricciuti; Gregorio P Milani; Silvia Tarantino; Roberta Ghilardi; Sebastiano A G Lava; Marco Alberzoni; Mario G Bianchetti; Carlo Agostoni Journal: Nutrients Date: 2020-05-17 Impact factor: 5.717
Authors: Andreas T Güntner; Julia F Kompalla; Henning Landis; S Jonathan Theodore; Bettina Geidl; Noriane A Sievi; Malcolm Kohler; Sotiris E Pratsinis; Philipp A Gerber Journal: Sensors (Basel) Date: 2018-10-28 Impact factor: 3.576