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Evaluation of three oral rehydration solutions designed for use in developed communities
E J Elliott1, R M Da Cunha Ferreira, D Cameron
1Department of Child Health, Queen Elizabeth Hospital for Children, London, UK.
Insights
Different oral rehydration solutions (ORS) effectively treated acute gastroenteritis in young children. However, high glucose ORS increased carbohydrate intolerance, while glycine ORS showed higher serum urea levels.
Area of Science:
- Pediatrics
- Gastroenterology
- Clinical Nutrition
Background:
- Acute gastroenteritis is a common cause of dehydration in infants.
- Oral rehydration solutions (ORS) are crucial for managing dehydration.
- Different ORS formulations exist, varying in electrolyte and carbohydrate content.
Purpose of the Study:
- To compare the efficacy and safety of three different ORS formulations in children under two years old with acute gastroenteritis.
- To assess clinical outcomes, electrolyte balance, and the incidence of carbohydrate intolerance.
Main Methods:
- 116 children under two years old with acute gastroenteritis were randomized into three groups.
- Each group received a different ORS: low sodium/high glucose, high sodium/low glucose, or glycine/glucose polymer.
- Clinical, biochemical, and hematological parameters were monitored.
Main Results:
- All three ORS formulations were effective in rehydration and correcting electrolyte abnormalities.
- Carbohydrate intolerance was more prevalent in the group receiving high glucose ORS.
- Higher serum urea levels were observed in the glycine-containing ORS group at 24 hours.
Conclusions:
- All tested ORS are safe and effective for rehydration in acute gastroenteritis.
- High glucose ORS may increase the risk of carbohydrate intolerance in children.
- Glycine-containing ORS requires further investigation regarding its effect on serum urea.
Abstract:
One hundred and sixteen children (less than 2 years old) admitted to a London hospital with acute gastroenteritis were randomized to receive either an oral rehydration solution (ORS) with low sodium and high glucose concentration (Na+ 35, glucose 200 mmol/L), an ORS with a high sodium but low glucose concentration (Na+ 60, glucose 111 mmol/L), or an ORS containing glycine and a glucose polymer (Na+ 50, glucose 50, glycine 50 mmol/L). Clinical, biochemical and haematological features of the three groups were similar on admission. Rotavirus was common (31%); the majority of children had minimal dehydration or acid-base disturbance. The clinical outcome, including ORS intake, prevention of dehydration, rehydration, and duration of hospital stay was similar in the three treatment groups. All initial electrolyte abnormalities were corrected; no child developed hypernatraemia or hyponatraemia. At 24 h, the mean serum urea was higher in those who received the ORS containing glycine than in other groups, and it had not fallen significantly since admission. Eighteen per cent of children had carbohydrate intolerance: four children with greater than or equal to 2% reducing substances in their stool had all received ORS with a high glucose content and had numerous watery green stools containing rotavirus. All ORS solutions were safe and effective for rehydration and correction of biochemical abnormalities, however carbohydrate intolerance was more prevalent in children who received the ORS with a high glucose content.