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Oral rehydration therapy: a Third World solution applied to intensive care
1Department of Anaesthesia and Intensive Care, Mater Hospital, Dublin, Ireland.
Intensive Care Medicine
|January 1, 1992
Summary
Oral rehydration therapy (ORT), a WHO-recommended treatment, was successfully used in intensive care for severe diarrhea and acute kidney injury. This cost-effective method improved renal function and maintained patient stability.
Area of Science:
- Critical Care Medicine
- Gastroenterology
- Nephrology
Background:
- Severe diarrhea in intensive care settings can lead to acute renal impairment.
- Oral rehydration therapy (ORT) is highly effective in reducing mortality from severe diarrhea but its intensive care application is unreported.
- The World Health Organisation (WHO) formula for ORT is a standard treatment for dehydration.
Observation:
- ORT was administered via nasogastric tube to three adult intensive care patients with severe diarrhea and post-operative acute renal impairment.
- Patients received a median intake of 2.2 L/day of ORT for a mean duration of 7 days.
- Hemodynamic and metabolic stability (Na, K, Mg, PO4, urea) were maintained during therapy.
Findings:
- Renal function significantly improved, with serum creatinine levels falling from a mean of 389 to 165 mmol/l.
- ORT effectively managed severe gastrointestinal losses in critically ill patients.
- While ORT may not reduce diarrhea volume, it addresses fluid and electrolyte imbalances.
Implications:
- ORT offers a cheap, effective, and physiological solution for managing severe gastrointestinal losses in intensive care.
- The findings suggest wider applicability of ORT in both adult and pediatric intensive care practices.
- This approach could potentially reduce the need for more invasive interventions for fluid and electrolyte management in critical care.