Triage administration of sucrose for gastroenteritis in children; a randomized controlled trial.

OBJECTIVES: Gastroenteritis is a common reason for pediatric emergency department (ED) visits. Fasting-induced ketosis has been proposed as a contributing factor that may exacerbate vomiting. We evaluated whether administration of a concentrated sucrose solution improves oral intake.

METHODS: We conducted a double-blind randomized controlled trial in a tertiary pediatric ED (2022-2024). Children aged 6 months to 7 years with vomiting most likely due to gastroenteritis were enrolled. Participants received a single dose of either sucrose solution (1.5 mL/kg, 3.5 g of sucrose/10 mL), or diluted juice alone (0.5 g of sucrose/10 mL), followed by oral rehydration therapy. The primary outcome was the volume of rehydration solution ingested (mL) within the first 2 h. Secondary outcomes included vomiting episodes, ondansetron use, return visits, and intravenous rehydration.

RESULTS: Of 2001 children screened, 240 (12.0%) were eligible and enrolled; 208 (92%) had primary outcome data. Participants were randomized to the sucrose group (n = 111) or the placebo group (n = 116). There was no significant difference in the volume of rehydration solution ingested between groups (84 mL vs 95 mL; mean difference - 11 mL; 95% CI -26 to 4). There were also no significant differences in the mean number of vomiting episodes (0.46 vs 0.47), intravenous rehydration (14% vs 12%), return visits (5% vs 4%) or ondansetron use (70% vs 68%).

CONCLUSION: A single dose of sucrose solution does not improve oral rehydration intake in children with gastroenteritis in the ED.