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[Comparative study of 2 oral rehydration solutions containing 60 or 90 mmol/L of sodium and with different
H Moreno-Sánchez1, L Velásquez-Jones, F C Becerra
1Hospital Infantil de Monterrey, Nuevo León, México, D.F.
Insights
A lower-osmolarity oral rehydration solution (ORS) showed better results in treating acute diarrhea in infants compared to the standard World Health Organization ORS. This ORS-60 reduced the need for intravenous rehydration, indicating improved oral rehydration therapy efficacy.
Area of Science:
- Pediatrics
- Gastroenterology
- Public Health
Background:
- Acute diarrhea is a leading cause of dehydration in infants globally.
- Oral rehydration therapy (ORT) is the primary treatment, but efficacy can vary.
- Standard World Health Organization ORS (ORS-90) has a high osmolality (311 mOsm/kg).
Purpose of the Study:
- To compare the efficacy of a reduced-osmolality ORS (ORS-60) with the standard WHO ORS (ORS-90) in treating acute diarrhea in infants.
- To evaluate the impact of different ORS formulations on the need for intravenous rehydration.
Main Methods:
- A randomized controlled trial involving 186 infants with acute diarrhea.
- Infants were divided into two groups: one receiving ORS-90 and the other receiving ORS-60 (240 mOsm/kg).
- Outcomes measured included the need for intravenous rehydration, serum electrolytes (sodium and potassium), and clinical status.
Main Results:
- Fewer infants in the ORS-60 group (2.5%) required intravenous rehydration compared to the ORS-90 group (8.3%).
- No significant differences were observed in serum sodium or potassium levels between the groups during or after rehydration.
- Both ORS formulations effectively corrected hypernatremia and hyponatremia.
Conclusions:
- Oral rehydration therapy with a reduced-osmolality ORS (ORS-60) is more effective in treating acute diarrhea in infants than the standard WHO ORS (ORS-90).
- ORS-60 demonstrates a lower failure rate, reducing the need for intravenous fluid administration.
- Further research is needed to confirm if ORS-60 also reduces fecal fluid loss during rehydration.
Abstract:
A total of 186 infants, suffering from acute diarrhea were studied and divided into two groups: 84 children were placed in group A and given the ORS recommended by the World Health Organization which contains sodium and glucose at concentrations of 60 and 90 mmol/L respectively and an osmolality of 311 mOsm/kg (mmol/kg) (ORS-90). Group B included 82 children who received an ORS containing sodium and glucose at concentrations of 60 and 90 mmol/L respectively and with an osmolality of 240 mOsm/kg (mmol/kg) (ORS-60). Seven belonging to group A (8.3%) required intravenous rehydration due to the severity of the diarrhea (three cases), persistent vomiting (three cases) and paralytic ileus (one case), while only two cases belonging to group B (2.5%) required intravenous rehydration due to severe losses through feces (one case) and another due to paralytic ileus (one case). No differences were observed due to the variations in sodium concentrations among either of the groups of patients, whether that be in the natremias when admitted or once rehydrated, with a general tendency towards the correction of the hypernatremia or hyponatremia seen during admittance with both types of ORS. A similar situation was observed with the variations in serum potassium. The results obtained from this study show the different advantages of using an ORS with lesser sodium and glucose concentrations as well as minor osmolality with those from using the solution recommended by the World Health Organization, when a lesser index of failures is observed in the treatment of children with acute diarrhea with oral rehydration therapy. Yet before widely recommending its' use, it should be demonstrated that the new ORS induces lesser losses through feces during the rehydrating period in children dehydrated due to acute diarrhea.