Related Experiment Videos
Oral rehydration of infants in a large urban U.S. medical center
Insights
Oral rehydration therapy (ORT) is a safe and effective treatment for acute gastroenteritis in infants. This study found ORT comparable to intravenous therapy, offering faster acidosis correction and better potassium management.
Area of Science:
- Pediatrics
- Gastroenterology
- Clinical Nutrition
Background:
- Acute gastroenteritis is a common cause of dehydration and acidosis in infants.
- Intravenous therapy has been the standard treatment, but it is invasive and costly.
Purpose of the Study:
- To compare the efficacy and safety of oral rehydration therapy (ORT) versus standard intravenous therapy in well-nourished infants with acute gastroenteritis.
Main Methods:
- A prospective randomized study involving 100 infants with dehydration and acidosis.
- Infants were assigned to either intravenous therapy or oral rehydration using specific electrolyte and glucose solutions.
- Clinical improvement, stool frequency, acidosis correction, and serum potassium levels were monitored.
Main Results:
- Oral rehydration was comparable to intravenous therapy in clinical improvement for 94% of infants.
- The oral rehydration group showed faster correction of acidosis and sustained higher serum potassium levels.
- No hyperkalemia was observed in the oral rehydration group, even with higher potassium concentrations than recommended.
Conclusions:
- Oral rehydration therapy is a safe, effective, and cost-efficient alternative to intravenous therapy for infants with acute gastroenteritis.
- ORT offers advantages in managing acidosis and maintaining adequate potassium levels.
- The findings support the wider adoption of ORT in clinical practice.
Abstract:
A prospective randomized study of 100 well-nourished infants with acute gastroenteritis resulting in dehydration and acidosis was carried out at the Jackson Memorial Hospital, Miami from 1981 to 1983. Patients were randomly assigned to receive either standard intravenous therapy or oral rehydration. Infants in the latter group first received solution A containing 75 mEq/L sodium, 30 mEq/L potassium, 75 mEq/L chloride [corrected], 30 mEq/L bicarbonate, and 2 gm/dL glucose [corrected]. After ad libitum feeding for six hours, solution B containing 50 mEq/L sodium, 30 mEq/L potassium, 50 mEq/L chlorine, 30 mEq/L bicarbonate, and 3 gm/dL [corrected] glucose was given. With three exceptions (6%), oral rehydration was comparable to the intravenous regimen in clinical estimates of improvement, although the oral group had more stools in the first day. The oral group had faster correction of acidosis and a sustained rise in serum potassium concentration, whereas in the intravenous group the potassium concentration showed first a drop with a later increase, but levels were at all times below those in the oral group. Although potassium was given from the beginning of oral rehydration, and at a higher concentration than recommended by the World Health Organization, no hyperkalemia occurred. We concluded that oral therapy is safe, less expensive for patients, and more convenient for the medical and nursing staffs.