Эффективность регидратирующей терапии при вирусных гастроэнтеритах у детей

Abstract

Aim: to compare the efficacy of reduced osmolarity oral rehydration solution (ORS) with zinc and infusion therapy with salt and sugar-salt solutions in children suffering from viral gastroenteritis (VGE) complicated by dehydration syndrome of I-II stage and II stage. Patients and Methods: a prospective open-ended comparative randomized clinical trial was conducted The children were divided into two groups: the main group (n=45) with therapy used reduced osmolarity ORS (carbohydrates 2.84 g, glucose 2.82 g, chlorides 0.453 g, zink 0.003 g, osmolarity: 245 mOsm/L, per 1 sachet), and the comparison group (n=34), receiving standard infusion therapy with salt-sugar solutions. The severity of acute gastroenteritis was assessed using a modified Vesikari score. Comprehensive clinical and laboratory examination of children was performed before and after treatment Results: the mean severity of the patients' condition on the modified Vesikari score was 13.26±0.7 points for VGE, which corresponds to the moderate severity. In 42 (93.3±4.5%) patients of the main group, the condition stabilization and reduction of pathological losses were achieved during the first 6 hours, and therefore oral rehydration was continued. In this case, the active use of ORS was conducted for 24–48 hours with an assessment of the trend in general and topical symptoms, as well as laboratory parameters of the fluid and electrolyte balance and renal excretion of nitrogenous compounds. 3 patients (6.66±3.7%) who required further parenteral fluid administration were excluded from the study due to the lack of proper oral rehydration effect associated with the vomiting and the impossibility of further therapeutic manipulations. During oral rehydration in the main group, the febrile reaction duration was comparable in the lasting with the comparison group. Normalization of general well-being in the form of the fatigue disappearance was noted in the compared groups at the same time, while the vomiting cessation was recorded in a significantly shorter time in the main group. Exicosis and diarrhea were managed to be stopped in the main and comparison groups at almost comparable time. Conclusion: rehydration with low-osmolar ORS helps to avoid possible complications of parenteral fluid administration and a traumatic situation for a child KEYWORDS: exicosis, dehydration syndrome, viral gastroenteritis, acute intestinal infection, oral rehydration, oral rehydration therapy, oral rehydration solution, zinc, low-osmolar oral rehydration solution, children. FOR CITATION: Bekhtereva M.K., Komarova A.M. Rehydration therapy efficacy of viral gastroenteritis in children. Russian Journal of Woman and Child Health. 2024;7(2):177–183 (in Russ.). DOI: 10.32364/2618-8430-2024-7-2-14.