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Trial registered on ANZCTR
Registration number
ACTRN12610000737033
Ethics application status
Approved
Date submitted
2/09/2010
Date registered
3/09/2010
Date last updated
11/11/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Randomized controlled trial of 4-hour versus 24-hour nasogastric rehydration in children with acute gastroenteritis and moderate dehydration
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Scientific title
Randomized controlled trial of the clinical efficacy and safety of 4-hour nasogastric rehydration in the Emergency Department versus 24-hour nasogastric rehydration in hospital in children with acute viral gastroenteritis and moderate dehydration
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Secondary ID [1]
252626
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute viral gastroenteritis with moderate dehydration
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Condition category
Condition code
Oral and Gastrointestinal
258298
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Nasogastric rehdydration is a standard treatment of mild to moderate dehydration in patients with gastroenteritis. A nasogastric tube is inserted through the nose into the stomach and oral rehydration fluid slowly infused, as clinically indicated.
Patients will be randomised to receive one of two nasogastric rehydration regimens:
1 - Rapid nasogastric rehydration (RNR) over 4 hours (100 ml/kg total); or
2 - Slow nasogastric rehydration (SNR) over 24 hours (replacement of 5-7% body weight over 24 hours)
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Intervention code [1]
257139
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Treatment: Drugs
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Comparator / control treatment
Patients will be treated with standard or rapid nasogastric rehydration, as randomised.
Standard nasogastric rehydration (SNR) involves replacement of the estimated fluid deficit (5-7% body weight) and maintenance requirements via a nasogastric tube over 24 hours in hospital.
Rapid nasogastric rehydration (SNR) involves replacement of 100mls/kg of oral rehydration solution via a nasogastric tube over 4 hours in the Emergency Department.
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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Clinical treatment failure of rehydration schedules defined as >2% body weight from time of admission after randomisation
Main outcome measures: body weight
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Assessment method [1]
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Timepoint [1]
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Admission to Emergency Department (enrolment and randomisation)
Reviews and measurement of body weight at 4-6 hours, 24 hours and 7 days from time of randomisation
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Secondary outcome [1]
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Secondary treatment failure is defined as:
1 - need for hospital admission at any time point after rapid rehydration (4 hrs), or re-admission after discharge from hospital for standard rehydration (24 hrs)
2 - need for insertion of intravenous (IV) cannula for IV rehydration for either rehydration schedule at any time point after randomisation
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Assessment method [1]
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Timepoint [1]
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Admission to Emergency Department (enrolment and randomisation)
Reviews at 4-6 hours, 24 hours and 7 days from time of randomisation
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Eligibility
Key inclusion criteria
Children with acute gastroenteritis and moderate dehydration presenting to the Emergency Department at 2 metropolitan paediatric teaching hospitals
Acute diarrhoea (non-bloody)
Moderate dehydration defined as 3 clinical signs (based on Gorelick study criteria)
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Minimum age
6
Months
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Maximum age
6
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1 - Bloody diarrhoea,
2 - Severe dehydration (dehydration score > 7)
3 - Mild dehydration (dehydration score < 3)
4 - Unable to obtain written informed consent,
5 - Patient living outside area covered by hospital-in-the-home (part of follow-up at 24 hrs and 7 days)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
15/05/2001
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Actual
15/05/2001
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Date of last participant enrolment
Anticipated
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Actual
15/11/2003
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Date of last data collection
Anticipated
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Actual
15/12/2003
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Sample size
Target
426
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Accrual to date
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Final
254
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
3212
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3052
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Recruitment postcode(s) [2]
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3021
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Department of Human Services
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Address [1]
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50 Lonsdale Street
Melbourne VIC 3000
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Royal Children's Hospital Melbourne
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Address
50 Flemington Road
Parkville, VIC 3052
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Sunshine Hospital
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Address [1]
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175 Furlong Road
St. Albans VIC 3021
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Royal Children's Hospital Melbourne
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Ethics committee address [1]
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50 Flemington Road Parkville VIC 3052
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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11/05/2001
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Ethics approval number [1]
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20128
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Summary
Brief summary
Objectives: To compare the efficacy of two nasogastric rehydration regimens in children with acute viral gastroenteritis. Patients and methods: Children aged 6-72 months with acute viral gastroenteritis and moderate dehydration were recruited from Emergency Departments (ED) at two metropolitan pediatric teaching hospitals. After a clinical assessment of the degree of dehydration, patients were randomized to receive either standard nasogastric rehydration (SNR) over 24 hours in the hospital ward, or rapid nasogastric rehydration (RNR) over 4 hours in the ED. Primary treatment failure was defined as weight loss of >2%, compared to the admission weight. Secondary treatment failure was defined as the need for (re-)admission to hospital, insertion of an intravenous line for rehydration or inability to tolerate nasogastric rehydration. Results: Of 9331 children with acute gastroenteritis screened, 228 children were recruited and randomized (RNR 119 [52.2%], SNR 109 [47.8%]). Baseline characteristics for both groups were similar. All patients made a full recovery without severe adverse events. Primary failure rate at 24 hrs was similar for RNR 12.6% (95% confidence interval [CI]; 6.6–18.6) and SNR 8.3% (95%CI; 3.1–13.5); p=0.12. Secondary treatment failure was more common in SNR patients 44% (95% CI; 34.6–53.4) vs RNR 31.1% (95%CI; 22.0–38.6); p=0.03. Discharge from the ED after RNR failed in 28 (23.5%) patients, and 9 (7.5%) were re-admitted within 24 hrs. Conclusion: Primary treatment failure and clinical outcomes were similar for RNR and SNR. While RNR generally reduced need for hospitalization, discharge home from the ED failed in about one quarter of patients.
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Trial website
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Trial related presentations / publications
Powell CV, Priestley SJ, Young S and Heine RG. Randomized clinical trial of rapid versus 24-hour rehydration for children with acute gastroenteritis. Pediatrics. 2011;128:e771-8
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Ralf Heine MD FRACP
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Address
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Dept of Gastroenterology & Clinical Nutrition
Royal Children’s Hospital
Parkville VIC 3052
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Country
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Australia
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Phone
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+61 3 9345 5060
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Fax
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+61 3 9345 6240
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Ralf Heine MD FRACP
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Address
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Dept of Gastroenterology & Clinical Nutrition
Royal Children’s Hospital
Parkville VIC 3052
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Country
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Australia
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Phone
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+61 3 9345 5060
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Fax
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+61 3 9345 6240
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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