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Safety and efficacy of three oral rehydration solutions for children with diarrhoea (Edinburgh 1984-85)
W A Cutting1, N R Belton, J A Gray
1Department of Child Life and Health, University of Edinburgh, UK.
Insights
Oral rehydration (OR) is effective for acute diarrhea in UK children. Three OR solutions with varying sodium and dextrose levels proved safe and effective, with no severe dehydration or fatalities observed.
Area of Science:
- Pediatrics
- Gastroenterology
- Public Health
Background:
- Acute diarrhea is a common pediatric illness.
- Severe dehydration requiring intravenous (IV) fluids is rare in UK children with acute diarrhea.
- Oral rehydration (OR) is a standard treatment approach.
Purpose of the Study:
- To evaluate the safety and efficacy of three different oral rehydration solutions.
- To compare the effectiveness of OR solutions with varying sodium and dextrose concentrations.
- To assess the incidence of hypernatremia in children treated with OR.
Main Methods:
- A double-blind, randomized trial involving 269 children with acute diarrhea.
- Administration of three OR solutions with distinct sodium (35, 50, 90 mmol/l) and dextrose (200, 111, 110 mmol/l) concentrations.
- Assessment of dehydration signs and biochemical parameters, including sodium levels.
Main Results:
- Only 5 (1.4%) of 357 children required IV infusions; none experienced severe dehydration.
- No fatalities occurred during the study period.
- All three OR solutions were found to be safe and effective, with no significant hypernatremia observed during or after treatment.
Conclusions:
- Oral rehydration is a safe and effective treatment for mild to moderate dehydration in children with acute diarrhea in the UK.
- The tested OR solutions, despite variations in composition, demonstrated comparable safety and efficacy.
- Current UK pediatric cases of acute diarrhea are generally mild, making OR the preferred management strategy.
Abstract:
Of 357 children with acute diarrhoea admitted to the City Hospital, Edinburgh, over a 12-month period, only 5 (1.4%) required IV infusions. Three hundred and nineteen were treated with oral rehydration (OR). Of these 269 were studied in detail and 43% had signs of dehydration, but in none of them was it severe. There were no fatalities. Patients were randomly allocated to treatment with one of three OR solutions in a double blind trial. The solutions had sodium concentrations of 35, 50 and 90 mmol (mEq)/l, and dextrose of 200 (36 g/l), 111 (20 g/l) and 110 (19.8 g/l) mmol/l, respectively. Hypernatraemia was not a clinical problem and only 5 children (2%) were biochemically hypernatraemic on admission. Treatment did not cause clinical hypernatraemia. At the second assessment only 3 children were biochemically hypernatraemic, one from each treatment group, and no one had clinical signs. All three solutions were safe and effective in the relatively mildly dehydrated patients currently seen in the UK.