Dehydration in non-diarrheal illnesses is usually overlooked. No consensus treatment recommendations for the management of dehydration in non-diarrheal illnesses exist. Thus a multi-disciplinary committee comprising 10 experts from India conducted a virtual advisory–board meeting in September 2020 to develop a consensus recommendation on current treatment strategies for managing oral fluid electrolytes and energy in pediatric patients during non-diarrheal illnesses. They also identified the unmet evidence-based needs and gaps.

A pre-meeting questionnaire-based voting system was utilized to reach a consensus followed by a discussion among the panel members. If a consensus was not made, the topic was debated to arrive at an aligned recommendation. 

Key clinical challenges are recognizing dehydration in acute illnesses and guiding the appropriate quantity and type of oral fluids based on symptom severity. This consensus statement guided the management of dehydration in non-diarrheal illnesses including a recommendation on oral fluid, electrolytes and suitable energy management in the pediatric population. 

The committee suggested the necessity for oral fluid, electrolyte and energy supplementation, which must be in accordance with the symptoms of acute non-diarrheal illness increased insensible losses and/or decreased intake. Oral rehydration fluids are to be prescribed accurately and at the right time for countering dehydration, ideally in the early period of illness. Prescribing pattern must be detailed and comparable to intravenous fluids. Carbonated drinks and canned juices should not be advised. Plain water solely may not replace electrolytes, especially for anorexic patients who can exclusively tolerate fluids. 

These clinical practice statements guide oral fluid, electrolyte and energy recommendations for pediatric patients with diverse acute illnesses beyond diarrhea. 

Further, the Physicians must recommend and monitor dehydration treatments in every patient with the same intensity similar to diarrhea. Properly managing fluid, electrolyte and energy (FEE) balance from an early course of illness is essential for recovery in every patient with acute illness, either diarrheal or nondiarrheal. Further research is required to manage the evidence gaps in managing dehydration in pediatric patients with various illnesses for improved results. 

Source: Research Square. 2022 DOI: https://doi.org/10.21203/rs.3.rs-1590086/v1