An international consensus report on a new algorithm for the management of infant diarrhoea

Fecha de publicación: 01/08/2016

Autores de IIS La Fe

Carmen Ribes Koninckx

Autor

Participantes ajenos a IIS La Fe

Lo Vecchio, A
Vandenplas, Y
Benninga, M
Broekaert, I
Falconer, J
Gottrand, F
Lifschitz, C
Lionetti, P
Orel, R
Papadopoulou, A
Salvatore, S
Shamir, R
Schappi, M
Staiano, A
Szajewska, H
Thapar, N
Wilschanski, M
Guarino, A

Grupos

Enfermedad celíaca e Inmunopatología digestiva

Abstract

Aim: Implementing international guidelines guarantees high standards of clinical care. A group of experts developed an algorithm to drive the management of common gastrointestinal symptoms in infancy by paediatricians and general practitioners. Methods: The algorithm started from the evidence-based recommendations of the European Society of Gastroenterology, Hepatology and Nutrition and the European Society of Pediatric Infectious Diseases and an updated review of the literature. We used the structured quantitative method of nominal group technique to reach a consensus. Results: A practical algorithm for the management of infants with acute diarrhoea was designed based on the consensus reached for each statement. The management of an infant with acute diarrhoea should include a sequence of actions: (i) a semiquantitative estimate of infant dehydration through validated clinical scores, (ii) rehydration therapy and early refeeding with breast milk or regular formula and (iii) effective agents to reduce the severity and duration of the diarrhoea. Finally, in children with prolonged diarrhoea, the search for aetiology should include persistent infections or reinfections, cows' milk protein allergy and coeliac diseases. Lactose should always be withdrawn. Conclusion: This algorithm provides an evidence-based sequence of interventions to optimise the management of infants with acute diarrhoea.

Datos de la publicación

ISSN/ISSNe:: 0803-5253, 1651-2227
Tipo:: Article
Páginas:: 384-389
DOI:: 10.1111/apa.13432
PubMed:: 27101938
Factor de Impacto:: 0,976 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Lo Vecchio, A:: Univ Naples Federico II, Paediat Sect, Dept Translat Med Sci, Via Pansini 5, I-80131 Naples, Italy
Vandenplas, Y:: Vrije Univ Brussel, UZ Brussel, Dept Paediat, Brussels, Belgium
Benninga, M:: Emma Childrens Hosp AMC, Dept Paediat, Amsterdam, Netherlands
Broekaert, I:: Univ Hosp Cologne, Dept Paediat, Cologne, Germany
Falconer, J:: Chelsea & Westmister NHS Healthcare Fdn, Dept Nutr & Dietet, London, England
Gottrand, F:: CHRU Lille, Jeanne de Flandre Univ Hosp, Fac Med, Dept Paediat, Lille, France
Lifschitz, C:: Hosp Italiano Buenos Aires, Sect Gastroenterol Hepatol & Transplantat, Dept Pediat, Buenos Aires, DF, Argentina
Lionetti, P:: Univ Florence, Meyer childrens Hosp, Dept Neurosci Pharmacol & Child Hlth, Florence, Italy
Orel, R:: Univ Childrens Hosp Ljubljana, Dept Gastroenterol Hepatol & Nutr, Ljubljana, Slovenia
Papadopoulou, A:: Univ Athens, Childrens Hosp Agia Sofia, Dept Paediat 1, Gastroenterol Unit, Thivon, Greece
Ribes-Koninckx, C:: La Fe Univ Hosp, Paediat Gastroenterol & Hepatol Unit, Valencia, Spain
Salvatore, S:: Univ Insubria, Dept Paediat, Varese, Italy
Shamir, R:: Tel Aviv Univ, Sackler Fac Med, Schneider Childrens Med Ctr Israel, Tel Aviv, Israel
Schappi, M:: Clin Grangettes, Paediat Ctr, Geneva, Switzerland

Ctr Med Univ Geneva, Geneva, Switzerland
Staiano, A:: Univ Naples Federico II, Paediat Sect, Dept Translat Med Sci, Via Pansini 5, I-80131 Naples, Italy
Szajewska, H:: Med Univ Warsaw, Dept Paediat, Warsaw, Poland
Thapar, N:: Great Ormond St Hosp Sick Children, Gastroenterol Unit, London, England

UCL Inst Child Hlth, London, England
Wilschanski, M:: Hadassah Hebrew Univ Med Ctr, Paediat Gastroenterol, Jerusalem, Israel
Guarino, A:: Univ Naples Federico II, Paediat Sect, Dept Translat Med Sci, Via Pansini 5, I-80131 Naples, Italy

Keywords

Algorithm; Dehydration; Gastroenteritis; Infant diarrhoea; Prolonged diarrhoea