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A comparative trial of rapid oral and intravenous rehydration in acute diarrhoea
Insights
Oral rehydration therapy (ORT) is as effective as intravenous (IV) therapy for treating acute diarrhea and dehydration in children. ORT led to faster weight gain and shorter diarrhea duration compared to IV therapy.
Area of Science:
- Pediatrics
- Gastroenterology
- Public Health
Background:
- Acute diarrhea and dehydration are significant causes of hospitalization in children under 5.
- Intravenous (IV) rehydration is a common but invasive treatment for severe dehydration.
- Oral rehydration therapy (ORT) offers a less invasive alternative.
Purpose of the Study:
- To compare the efficacy and outcomes of oral rehydration therapy (ORT) versus intravenous (IV) rehydration in hospitalized children with acute diarrhea and dehydration.
Main Methods:
- A randomized controlled trial involving 37 children under 5 years old hospitalized for acute diarrhea and dehydration.
- Participants were assigned to receive either oral or intravenous rehydration over 6 to 12 hours.
- Outcomes measured included rehydration status, correction of metabolic acidosis and sodium deficit, feeding tolerance, weight gain, and diarrhea duration.
Main Results:
- Both ORT and IV therapy effectively corrected dehydration, metabolic acidosis, and sodium deficits at similar rates.
- Normal feeding was successfully reintroduced in most children receiving ORT, but often unsuccessful in the IV group.
- Children treated with ORT showed a 2.9% weight gain by discharge, while IV-treated children did not gain weight.
- The duration of diarrhea was shorter in the ORT group.
Conclusions:
- Oral rehydration therapy is an effective and potentially superior alternative to intravenous rehydration for managing acute diarrhea and dehydration in children.
- ORT facilitates quicker return to normal feeding and promotes weight gain during hospitalization.
- These findings support the wider implementation of ORT in pediatric care settings.
Abstract:
37 children under the age of 5 years hospitalized for acute diarrhoea and dehydration were randomized to receive oral or intravenous rehydration during 6 to 12 hours. Rehydration was satisfactory in both groups, with correction of dehydration, metabolic acidosis and sodium deficit at equal rates. The reintroduction of normal feedings was successful in most of the orally rehydrated children after 12 hours, but often unsuccessful in the i.v. therapy group. Consequently the orally rehydrated children showed a 2.9% weight gain by the time of discharge whereas the intravenously treated children did not gain weight in the hospital. The duration of diarrhoea was also shorter in the orally rehydrated children. Thus oral rehydration therapy was equal or superior to even rapid intravenous rehydration therapy in the management of acute diarrhoea in children.