Oral Glucose Intervention for Children With Gastroenteritis and Ketosis
| Status: | Not yet recruiting |
|---|---|
| Conditions: | Gastrointestinal |
| Therapuetic Areas: | Gastroenterology |
| Healthy: | No |
| Age Range: | 1 - 7 |
| Updated: | 12/31/2017 |
| Start Date: | January 2018 |
| End Date: | December 2018 |
| Contact: | Fred R Guyer, MD |
| Email: | fguyer@ufl.edu |
| Phone: | 904-226-5047 |
Fasting ketoacidosis adds morbidity to children affected by gastrointestinal infections. The
investigators investigate oral glucose gel for its effectiveness in rapidly reducing
ketoacidosis and for improvements in oral hydration therapy success.
investigators investigate oral glucose gel for its effectiveness in rapidly reducing
ketoacidosis and for improvements in oral hydration therapy success.
More than 1.7 million children with acute gastroenteritis present for emergency department
(ED) care annually in the United States. Gastroenteritis treatment regimens have been
outlined in guidelines endorsed by the American Academy of Pediatrics, European Society of
Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), and Center for Disease Control
(CDC). A fundamental principle included in these guidelines is the administration of oral
rehydration therapy (ORT) to the vast majority of children with gastroenteritis; however,
surveys have shown that a gap exists between guidelines and practice. Fasting ketoacidosis is
an increasingly recognized metabolic derangement for children presenting with symptoms
suggestive of gastroenteritis and mild to moderate dehydration. Ketoacidosis frequently
occurs and likely adds comorbid symptoms of lethargy, vomiting, and malaise. These symptoms
likely impair successful oral rehydration interventions. These symptoms may also lead to
overestimations of the severity of dehydration. Rapid recognition of ketoacidosis is now
possible with point of care testing beta-hydroxybutyrate. This investigation will determine
if an oral glucose gel intervention will improve the Point Of Care (POC) beta-hydroxybutyrate
from baseline. Secondary outcomes measured will include net fluid volume intake estimates,
need for IV hydration, and need for hospitalization.
(ED) care annually in the United States. Gastroenteritis treatment regimens have been
outlined in guidelines endorsed by the American Academy of Pediatrics, European Society of
Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), and Center for Disease Control
(CDC). A fundamental principle included in these guidelines is the administration of oral
rehydration therapy (ORT) to the vast majority of children with gastroenteritis; however,
surveys have shown that a gap exists between guidelines and practice. Fasting ketoacidosis is
an increasingly recognized metabolic derangement for children presenting with symptoms
suggestive of gastroenteritis and mild to moderate dehydration. Ketoacidosis frequently
occurs and likely adds comorbid symptoms of lethargy, vomiting, and malaise. These symptoms
likely impair successful oral rehydration interventions. These symptoms may also lead to
overestimations of the severity of dehydration. Rapid recognition of ketoacidosis is now
possible with point of care testing beta-hydroxybutyrate. This investigation will determine
if an oral glucose gel intervention will improve the Point Of Care (POC) beta-hydroxybutyrate
from baseline. Secondary outcomes measured will include net fluid volume intake estimates,
need for IV hydration, and need for hospitalization.
Inclusion Criteria:
- Participants with gastroenteritis presenting to UF Health Shands Emergency Department
Exclusion Criteria:
- hypoglycemic- Blood glucose less than 50 or hyperglycemic- greater than 200
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