Challenges

Determining the ideal level of hydration, accurate and timely diagnosis of dehydration remains a challenge.¹

Recommending the appropriate quantity and type of oral fluids based on symptom severity¹

Expert Panel

• An expert panel comprising six paediatricians, two paediatric gastroenterologists and two nutritionists convened via virtual meetings¹
• A pre-meeting questionnaire-based voting system was adopted to reach consensus, and where there was no consensus, the topic was open for debate to arrive at a conclusive statement¹

Consensus

Oral FEE recommendation aims at replacing losses of fluids and electrolytes and should be recommended until patient recovers from the underlying condition¹

It is important to monitor the patients clinical status to assess dehydration before deciding on oral fluid therapy.

Clear homemade fluids, coconut water, oral rehydration fluids, RTD with electrolytes and energy are the most recommended fluids¹

Carbonated drinks, canned juices, ready made tea and plain water should not be recommended¹

Recommendations

Physicians should recommend and monitor dehydration treatments in every patient with the same intensity as for conditions with diarrhea¹

Appropriate management of FEE balance early in the course of illness is essential for recovery in pediatric patients with acute illness, whether diarrheal or non-diarrheal¹

RTD formats and premixed ORS are preferable due to their known concentration of electrolytes and palatable taste to increase compliance in children versus the variable homemade solutions, which may have errors in preparation¹

Oral rehydration with FEE should be recommended as part of core treatment from Day 1 of acute non-diarrheal illnesses for improved patient outcomes¹

FEE = Fluids, Electrolytes, and Energy; RTD = Ready to Drink

Reference:

1. Ghosh A, Bavdekar AR , Wadhwa N, et al. Role of Oral Fluid, Electrolytes and Energy in various pediatric illnesses beyond Diarrhea: An Indian Expert Panel Consensus Recommendation. Presented at 59th Annual Conference of the Indian Academy of Pediatrics PEDICON 2022 NOIDA, March 19 13, 2022, New Delhi, India.