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Dari beberapa milis
dilaporkan bahwa OBAT MUNTAH TIDAK BOLEH DIBERIKAN.
Saya baru mendapatkan
journal ilmiah dari NEJM terbaru yang menggunakan obat muntah pada kasus
Gastroenteritis dengan Dehidrasi.
Kira kira isinya adalah
pemakaian ondansetron pada anak dengan muntah berak, dapat mengurangi frekuensi
muntah dan lebih memungkinkan pemberian oralit (rehidrasi peroral).
Semoga menambah
Wawasan.
Oral
Ondansetron for Gastroenteritis in a Pediatric Emergency
Department
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Previous
Translated Abstracts
Background Vomiting limits the success
of oral rehydration in children with gastroenteritis. We conducted a
double-blind trial to determine whether a single oral dose of
ondansetron, an antiemetic, would improve outcomes in children with
gastroenteritis.
Methods We enrolled 215 children 6 months through 10 years of
age who were treated in a pediatric emergency department for
gastroenteritis and dehydration. After being randomly assigned
to treatment with orally disintegrating ondansetron tablets or
placebo, the children received oral-rehydration therapy according to
a standardized protocol. The primary outcome was the proportion who
vomited while receiving oral rehydration. The secondary outcomes were
the number of episodes of vomiting and the proportions who were
treated with intravenous rehydration or hospitalized.
Results As compared with children who received placebo, children
who received ondansetron were less likely to vomit (14 percent
vs. 35 percent; relative risk, 0.40; 95 percent confidence interval,
0.26 to 0.61), vomited less often (mean number of episodes per
child, 0.18 vs. 0.65; P<0.001), had greater oral intake (239
ml vs. 196 ml, P=0.001), and were less likely to be treated by
intravenous rehydration (14 percent vs. 31 percent; relative risk,
0.46; 95 percent confidence interval, 0.26 to 0.79). Although the
mean length of stay in the emergency department was reduced by 12
percent in the ondansetron group, as compared with the placebo group
(P=0.02), the rates of hospitalization (4 percent and 5 percent,
respectively; P=1.00) and of return visits to the emergency
department (19 percent and 22 percent, P=0.73) did not differ
significantly between groups.
Conclusions In children with gastroenteritis and dehydration,
a single dose of oral ondansetron reduces vomiting and facilitates
oral rehydration and may thus be well suited for use in the
emergency department.
Source
Information
From the Division of Pediatric Emergency Medicine, Hospital for Sick Children, University of Toronto, Toronto (S.B.F.); the Division of Pediatric Emergency Medicine (M.A., E.C.P.) and the Mary Ann and J. Milburn Smith Child Health Research Program (R.S.), Children's Memorial Research Center, Children's Memorial Hospital, Chicago; and the Departments of Pediatrics (M.A., R.S., E.C.P.) and Preventive Medicine (R.S.), Feinberg School of Medicine, Northwestern University, Chicago.
Address reprint requests to Dr. Freedman at the Division of Pediatric Emergency Medicine, Hospital for Sick Children, 555 University Ave., Toronto ON M5G 1X8, Canada, or at [EMAIL PROTECTED] .
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