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Oral rehydration solution without bicarbonate
Insights
Oral rehydration solution without bicarbonate effectively treats dehydration and acidosis in children with acute watery diarrhea. While initial acidosis correction is slower, it becomes comparable to WHO oral rehydration solution within 48 hours.
Area of Science:
- Pediatrics
- Gastroenterology
- Clinical Trials
Background:
- Acute watery diarrhea in children often leads to dehydration and acidosis.
- Standard oral rehydration solution (ORS) typically includes bicarbonate to correct acidosis.
- The efficacy of ORS without bicarbonate requires further investigation.
Purpose of the Study:
- To compare the efficacy of oral rehydration solution without bicarbonate versus the World Health Organization (WHO) ORS in treating dehydration and acidosis in young children.
- To assess treatment success rates and the speed of acidosis correction.
Main Methods:
- A double-blind, randomized clinical trial involving 98 young children with acute watery diarrhea.
- Children presented with varying degrees of dehydration and acidosis.
- Treatment groups received either ORS without bicarbonate or WHO ORS.
Main Results:
- The non-bicarbonate ORS group showed successful treatment in all but three children, attributed to persistent vomiting and severe diarrhea.
- Acidosis correction was slower in the non-bicarbonate group during the first 24 hours (P < 0.001).
- By 48 hours, acidosis was corrected in both groups, with comparable serum bicarbonate levels (P > 0.05).
Conclusions:
- Oral rehydration solution without bicarbonate is a viable alternative when the complete WHO formula is unavailable.
- Treatment failures may occur due to persistent vomiting and severe diarrhea.
- While initial acidosis correction is slower, non-bicarbonate ORS effectively manages dehydration and acidosis in children.
Abstract:
The efficacy of oral rehydration solution without bicarbonate was compared with World Health Organisation oral rehydration solution in 98 young children in a double blind and randomised clinical trial. These children had varying degrees of dehydration and acidosis caused by acute watery diarrhoea. The mean serum bicarbonate concentration on admission was 13.3 mmol(mEq)/1 in the former and 13.1 mmol(mEq)/1 in the latter group of children. All but three children who received the rehydration solution without bicarbonate were successfully treated; three treatment failures were attributed to persistent vomiting and severe diarrhoea (greater than 10 ml/kg/hour). Correction of acidosis was slower in the non-bicarbonate treated than the control group during the first 24 hours' treatment (P less than 0.001). By 48 hours, however, acidosis was corrected and mean serum bicarbonate had risen to 17.1 mmol(mEq)/1 compared with 18.9 mmol(mEq)/1 in the control group (P greater than 0.05). Some failures due to sustained acidosis and persistent vomiting and diarrhoea should be expected. Oral rehydration solution without bicarbonate may be used where complete formula solution is not available.