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National Collaborating Centre for Women's and Children's Health (UK). Diarrhoea and Vomiting Caused by Gastroenteritis: Diagnosis, Assessment and Management in Children Younger than 5 Years. London: RCOG Press; 2009 Apr. (NICE Clinical Guidelines, No. 84.)

Search strategies

4. Assessing dehydration and shock

Clinical question

How do we clinically assess dehydration in a child with gastroenteritis? What are the best signs/symptoms for predicting the degree of dehydration in children with gastroenteritis? What signs/symptoms are associated with hypernatremic dehydration?

DNV_predicting_dehydration_medline_130308 (Ovid MEDLINE 1950 to March Week 1 2008)

DNV_predicting_dehydration_embase_130308 (EMBASE 1980 to 2008 Week 10)

DNV_predicting_dehydration_cinahl_130308 (CINAHL 1982 to February Week 5 2008)

Clinical question

How can dehydration best be clinically assessed in children less than five years of age with gastroenteritis? What factors are associated with an increased risk of dehydration?

DNV_risk_factors_medline_100308 (Ovid MEDLINE 1950 to February Week 4 2008)

DNV_risk_factors_embase_100308 (EMBASE 1980 to 2008 Week 09)

DNV_risk_factors_cinahl_100308 (CINAHL 1982 to February Week 5 2008)

Clinical question

What investigations should be performed as part of the assessment of a child with gastroenteritis? Specifically as a result of dehydration (of any degree) and/or of shock? When should specialised tests be carried out?

DNV_assessment_medline_240408 (Ovid MEDLINE 1950 to April Week 3 2008)

DNV_assessment_embase_250408 (EMBASE 1980 to 2008 Week 17)

DNV_assessment_cinahl_250408 (CINAHL 1982 to April Week 3 2008)

Clinical question

What investigations should be performed as part of the assessment of a child with gastroenteritis?

  1. Specifically as a result of dehydration (of any degree) and/or of shock
  2. When should specialised tests be carried out?

DNV_assessment_economics_medline_230508 (Ovid MEDLINE 1950 to May Week 2 2008)

DNV_assessment_economics_eedhta_230508 (CLHTA, CLEED)

DNV_assessment_economics_embase_230508 (EMBASE 1980 to 2008 Week 21)

5. Fluid management

Clinical question

Which is more cost effective, ORT or IV, in children under 5?

DNV_oral_vs_iv_economic_medline_240907 (Ovid MEDLINE 1950 to September Week 2 2007)

DNV_oral_vs_iv_economic_embase_240907 (EMBASE 1980 to 2007 Week 38)

DNV_oral_vs_iv_economic_cdsrdare_240907 (CDSR (coch), DARE)

Clinical question

Is oral rehydration therapy in children under five with dehydration due to gastroenteritis more effective and safer than IV in children with severe or hypernatremic dehydration?

DNV_oral_vs_iv_severe_hypernat_medline_221007 (Ovid MEDLINE 1950 to October Week 2 2007)

DNV_oral_vs_iv_severe_hypernat_embase_221007 (EMBASE 1980 to 2007 Week 42)

DNV_oral_vs_iv_severe_hypernat_cinahl_221007 (CINAHL 1982 to October Week 2 2007)

Clinical question

What strategies are effective in preventing dehydration in children with gastroenteritis?

  1. Does oral fluid supplementation prevent dehydration?
  2. Which oral fluid is most effectie in preventing dehydration?
  3. What oral fluid supplementation regime should be used?
  4. What factors should be taken into consideration when giving oral fluid supplementation?

DNV_oral_fluid_prevent_medline_251007 (Ovid MEDLINE 1950 to October Week 3 2007)

DNV_oral_fluid_prevent_embase_251007 (EMBASE 1980 to 2007 Week 42)

DNV_oral_fluid_prevent_cinahl_261007 (CINAHL 1982 to October Week 3 2007)

Clinical question

Is oral rehydration therapy in children under five with dehydration due to gastroenteritis more cost effective than IV in children with hypernatremic dehydration?

DNV_oral_vs_iv_hypernat_economics_medline_301007 (Ovid MEDLINE 1950 to October Week 3 2007)

DNV_oral_vs_iv_hypernat_economics_embase_301007 (EMBASE 1980 to 2007 Week 43)

DNV_oral_vs_iv_hypernat_economics_eed_301007

Clinical question

What is the effectiveness and safety of oral rehydration therapy compared with IV therapy for the treatment of dehydration in the following:

  1. children with mild dehydration?
  2. children with moderate dehydration?
  3. children with severe dehydration?
  4. children with hypernatremic dehydration?

DNV_oral_vs_IV_medline _290507 (Ovid MEDLINE(R) 1950 to September Week 3 2007)

DNV_oral_vs_IV_embase _290507 (EMBASE 1980 to 2008 Week 39)

DNV_oral_vs_IV_cinahl _290507 (CINAHL 1982 to September Week 4 2008)

Clinical question

What strategies are cost effective in preventing dehydration in children with gastroenteritis?

  1. Which oral fluid is most cost effective in preventing dehydration?
  2. What oral fluid supplementation regime should be used?
  3. What factors should be taken into consideration when giving oral fluid supplementation?

DNV_oral_fluid_prevent_economics_medline_311007 (Ovid MEDLINE 1950 to October Week 3 2007)

DNV_oral_fluid_prevent_economics_embase_311007 (EMBASE 1980 to 2007 Week 43)

DNV_oral_fluid_prevent_economics_crd_311007 (CRD (HTA, DARE, EED))

Clinical question

In children treated with oral fluid what strategy should be used?

  1. Which oral fluid is most effective in treating dehydration
  2. When ORS is being used which composition of ORS is the most effective?
  3. What oral fluid regime should be used?
  4. What factors should be taken into consideration when giving oral fluid supplementation?

DNV_oral_fluid_therapy_medline_141107 (Ovid MEDLINE 1950 to October Week 5 2007)

DNV_oral_fluid_therapy_embase_141107 (EMBASE 1980 to 2007 Week 45)

DNV_oral_fluid_therapy_cinahl_141107 (CINAHL 1982 to November Week 2 2007)

Clinical question

In children being given IV therapy, what fluid regime should be used?

DNV_iv_fluid_regime_medline_131207 (Ovid MEDLINE 1950 to November Week 2 2007)

DNV_iv_fluid_regime_embase_141207 (EMBASE 1980 to 2007 Week 50)

DNV_iv_fluid_regime_cinahl_141207 (CINAHL 1982 to December Week 1 2007)

Clinical question

What is the risk of recurrence of dehydration in children with gastroenteritis?

DNV_risk_dehydration_recurrence_medline_140108 (Ovid MEDLINE 1950 to January Week 1 2008)

DNV_risk_dehydration_recurrence_embase_140108 (EMBASE 1980 to 2008 Week 02)

DNV_risk_dehydration_recurrence_cinahl_140108 (CINAHL 1982 to December Week 1 2007)

Clinical question

What [oral fluid] interventions are safe and effective in preventing the recurrence of dehydration?

DNV_prevent_dehydration_recurrence_medline_150108 (Ovid MEDLINE 1950 to January Week 1 2008)

DNV_prevent_dehydration_recurrence_embase_150108 (EMBASE 1980 to 2008 Week 02)

DNV_prevent_dehydration_recurrence_cinahl_150108 (CINAHL 1982 to December Week 1 2007)

Clinical question

What [oral fluid] interventions are cost effective in preventing the recurrence of dehydration?

DNV_prevent_dehydration_recurrence_economics_medline_150108 (Ovid MEDLINE 1950 to January Week 1 2008)

DNV_prevent_dehydration_recurrence_economics_embase_150108 (EMBASE 1980 to 2008 Week 02)

DNV_prevent_dehydration_recurrence_economics_crd_150108

Clinical question

Following rehydration, what feeding regimes are appropriate for children under 5 years?

DNV_post_rehydration_feeding_medline_290108 (Ovid MEDLINE 1950 to January Week 3 2008)

DNV_post_rehydration_feeding_embase_290108 (EMBASE 1980 to 2008 Week 04)

DNV_post_rehydration_feeding_cinahl_290108 (CINAHL 1982 to December Week 1 2007)

7. Antibiotic therapy

Clinical question

What is the incubation period or infectiousness of Shigella?

DNV_shigella_medline_080508 (Ovid MEDLINE 1950 to April Week 5 2008)

Clinical question

What is the incubation period or infectiousness of Campylobacter enteritis?

DNV_campylobacter_medline_080508 (Ovid MEDLINE 1950 to April Week 5 2008 )

Clinical question

What is the incubation period or infectiousness of salmonellosis?

DNV_salmonellosis_medline_080508 (Ovid MEDLINE 1950 to April Week 5 2008 )

Clinical question

What role, if any, does antibiotic therapy have in the treatment of children with gastroenteritis? What are the indications for administering antibiotics in children with the following bacterial forms of gastroenteritis?

DNV_antibiotic_therapy_medline_160508 (Ovid MEDLINE 1950 to May Week 1 2008 )

DNV_antibiotic_therapy_embase_190508 (EMBASE 1980 to 2008 Week 20)

DNV_antibiotic_therapy_cinahl_190508 (CINAHL 1982 to May Week 3 2008)

Clinical question

What interventions, other than fluid therapy (if any) are cost-effective and safe for children with gastroenteritis? B. What are the indications for administering antibiotics in children with the following bacterial forms of gastroenteritis?

DNV_alternative_antibiotic_therapies_medline_economics_270508 (Ovid MEDLINE 1950 to May Week 2 2008)

DNV_alternative_antibiotic_therapies_economics_eedhta_270508 (CLHTA, CLEED)

DNV_alternative_antibiotic_therapies_economics_embase_270508 (EMBASE 1980 to 2008 Week 21)

8. Other therapies

Clinical question

What interventions, other than fluid therapy (if any) are effective and safe for children with gastroenteritis? Are any of the following effective and safe for children under 5, with gastroenteritis?

DNV_alternative_therapies_medline_220408 (Ovid MEDLINE 1950 to April Week 2 2008)

DNV_alternative_therapies_embase_220408 (EMBASE 1980 to 2008 Week 16)

DNV_alternative_therapies_cinahl_220408 (CINAHL 1982 to April Week 3 2008)

Copyright © 2009, National Collaborating Centre for Women’s and Children’s Health.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK [www.cla.co.uk]. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

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Cover of Diarrhoea and Vomiting Caused by Gastroenteritis
Diarrhoea and Vomiting Caused by Gastroenteritis: Diagnosis, Assessment and Management in Children Younger than 5 Years.
NICE Clinical Guidelines, No. 84.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2009 Apr.

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