Intravenous rehydration for diarrheal dehydration of eutrophic children: survey of protocols provided at Colombian medical schools Encuesta nacional sobre los conocimientos impartidos en escuelas de medicina de Colombia sobre rehidratación parenteral en ni os eutróficos mayores de un a o con deshidratación por enfermedad diarreicaIván

Introduction. In all cases of severe dehydration from diarrhea, WHO recommends rapid rehydration. If oral rehydration in children is contraindicated, intravenous rehydration is recommended for immediate administration. However, methods of intravenous rehydration appear to be inadequately addressed in the medical schools of Colombia.Objective. Current approaches to oral rehydration were summarized, and instructors were informed concerning current WHO recommendations.Materials and methods. A survey was designed for pediatric instructors in Colombian medical schools. Direct questions about rehydration methods were included as well as presentation of theoretical clinical situations with dehydrated children. The survey also asked for the conditions necessary for intravenous rehydration and method of administration (volume, solution, concentration and speed of infusion).Results. Forty-one surveys were included (82% of medical schools in Colombia). Inadequate contraindications for oral rehydration therapy were made in 41%. Rapid and slow intravenous rehydration was recommended in 71% and 29%, respectively; 57% recommended fluid bolus to rehydrate. Adequate volumes were recommended by less than half of the respondents and adequate sodium concentration was recommended by 85%. In 56% of medical schools, glucose was not included in solutions and 66% use Ringer lactate. Normal saline solution, dextrose solution with electrolytes and polyelectrolytes solutions are also used.Conclusions. Misconceptions are common concerning the contraindications to oral rehydration therapy. One-third of medical schools promote a slow therapy despite the superiority of the rapid therapy. Uniformity for rapid therapy schemes is lacking. Bolus rehydration is commonly advocated 11despite the fact that this method is unsupported by the literature. Concepts about rehydration must be updated in medical schools and a national guide for intravenous rehydration is recommended. Introducción. Ante la deshidratación grave por diarrea y la contraindicación para rehidratación oral, la rehidratación en ni os debe realizarse por vía intravenosa. La Organización Mundial de la Salud (OMS) recomienda la rehidratación rápida.Objetivos. Describir los métodos de rehidratación intravenosa ense ados en las escuelas de medicina colombianas y confrontarlos con las recomendaciones de la OMS.Materiales y métodos. Se elaboró una encuesta para docentes de pediatría en escuelas de medicina. Se hicieron preguntas directas y se detallaron casos clínicos de ni os deshidratados para ser resueltos. Se preguntó por las in