Large-Volume No Better Than Standard-Volume IV Rehydration in Stable Children with Gastroenteritis

In a randomized controlled trial in a single pediatric emergency department, 226 hemodynamically stable children (age, 3 months to 11 years; weight, 5–33 kg) with gastroenteritis who failed oral rehydration received either a 20 mL/kg (standard volume) or a 60 mL/kg (large volume) intravenous (IV) normal saline infusion over 1 hour, followed by 5% dextrose in normal saline at maintenance rate. Dehydration was defined as a score >3 on a validated 8-point, 4-item (general appearance, eyes, mucous membranes, tears) clinical dehydration scale.

Rehydration (dehydration scale score ≤1) within 2 hours — the primary outcome — was achieved in similar proportions of patients in the large-volume and standard-volume groups (36% and 29%). However, median …