Challenge

• No standard set of signs and symptoms for assessment of dehydration¹

• Non-diarrheal conditions like fever, general weakness, nausea & vomiting, upper respiratory tract infections, urinary tract infections, dengue, malaria may lead to dehydration which often goes unrecognized¹

A modified Delphi approach^* designed using an online survey form followed by a virtual meeting was used to develop the consensus recommendation¹

Expert Panel

The Delphi panel consisted of 10 national experts¹

• Gastrosurgeon

• Gastroenterologist

• Internal Medicine Physician

• Dietician

• Diabetologist

• Infectious disease and critical care specialist

Consensus Recommendations**

• Screen all patients > 60 years of age for low-intake dehydration¹

• Type 2 diabetes mellitus (T2DM) patients are prone to dehydration and electrolyte abnormalities¹

• Nutrition and hydration are central to recovery from acute illnesses like fever, eneral weakness, nausea & vomiting, upper respiratory tract infections, urinary tract infections, dengue, malaria¹

Energy/caloric Requirements

• The patient will need more calories and energy than available in a normal diet to compensate and meet the increased energy demands needs close monitoring¹

• Oral fluid and electrolyte formulations should include adequate caloric content to address the FEE requirements¹

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

*The Delphi technique is a systematic process of forecasting using the collective opinion of panel members. Delphi method is used to develop best practice guidance using collective intelligence where research is limited, ethically/logistically difficult or evidence is conflicting.² **These consensus recommendations provide guidance for oral FEE recommendations for adult/geriatric patients with various non-diarrheal illnesses¹ Scientific facts only. Reference material for Registered Medical Practitioners Only

References:

1. Reddy BR, Nigam A, Gogia A, et Oral Fluid, Electrolytes and Energy Management in Various Adult and Geriatric Illnesses. Presented at ASPEN 2022, March 26-29, 2022, Seattle, Washington, USA & Virtual.

2. Nasa P, Jain R, Juneja Delphi methodology in healthcare research: How to decide its appropriateness. World J Methodol. 2021 Jul 20;11(4):116-129.