Pediatric gastroenteritis in the emergency department: practice evaluation in Belgium, France, The Netherlands and Switzerland

BMC Pediatrics

François Angoulvant⁶  Vincent Gajdos⁸  Rianne Oostenbrink³  Mathie Lorrot⁵  Juan Llor¹  Sébastien Julliand²  Sébastien Redant⁴  Raphaëlle Pelc⁷ 

[1] Department of Medical and Surgical Pediatric, Hôpital du Valais, Centre Hospitalier du Valais Romand, Sion, Switzerland;Department of Pediatric Emergency, AP-HP, Hôpital Robert Debré, Université Paris Diderot, Sorbonne Paris Cité, Paris, France;Department General Pediatrics, Erasmus MC-Sophia Hospital, Rotterdam, Netherlands;Pediatric Emergency Department, Queen Fabiola Hospital, Brussels, Belgium;Department General Pediatrics, AP-HP, Hôpital Robert Debré, Université Paris Diderot, Sorbonne Paris Cité, Paris, France;Department of Pediatric Emergency, AP-HP, Hôpital Necker-Enfants Malades, Université Paris Descartes, Sorbonne Paris Cité, 149 rue de Sèvres, 75015 Paris, France;Department General Pediatrics, CHI de Creteil, Creteil, France;Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Reproduction and Child Development Team, Villejuif, France

关键词: Rehydration;    Practice patterns;    Pediatric emergency department;    Acute gastroenteritis;   

Others  :  1138859
DOI  :  10.1186/1471-2431-14-125

 received in 2014-01-28, accepted in 2014-05-07,  发布年份 2014

【 摘 要 】

Background

Based on European recommendations of ESPGHAN/ESPID from 2008, first line therapy for dehydration caused by acute gastroenteritis (AGE) is oral rehydration solution (ORS). In case of oral route failure, nasogastric tube enteral rehydration is as efficient as intra-venous rehydration and seems to lead to fewer adverse events. The primary objective was to describe rehydration strategies used in cases of AGE in pediatric emergency departments (PEDs) in Belgium, France, The Netherlands, and Switzerland.

Methods

An electronic survey describing a scenario in which a toddler had moderate dehydration caused by AGE was sent to physicians working in pediatric emergency departments. Analytical data were analyzed with descriptive statistics and Kruskal –Wallis Rank test.

Results

We analyzed 68 responses, distributed as follows: Belgium N = 10, France N = 37, The Netherlands N = 7, and Switzerland N = 14. Oral rehydration with ORS was the first line of treatment for 90% of the respondents. In case of first line treatment failure, intravenous rehydration was preferred by 95% of respondents from France, whereas nasogastric route was more likely to be used by those from Belgium (80%), The Netherlands (100%) and Switzerland (86%). Serum electrolyte measurements were more frequently prescribed in France (92%) and Belgium (80%) than in The Netherlands (43%) and Switzerland (29%). Racecadotril was more frequently used in France, and ondansetron was more frequently used in Switzerland. No respondent suggested routine use of antibiotics.

Conclusion

We found variations in practices in terms of invasiveness and testing. Our study supports the need for further evaluation and implementation strategies of ESPGHAN/ESPID guidelines. We plan to extend the study throughout Europe with support of the Young ESPID Group.

【 授权许可】

   
2014 Pelc et al.; licensee BioMed Central Ltd.

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