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Use of a single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate
M B Cohen1, A G Mezoff, D W Laney
1Division of Pediatric Gastroenterology and Nutrition, Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Insights
This study found both glucose-based (Pedialyte) and rice syrup solids-based (Infalyte) oral rehydration solutions effectively rehydrate infants with mild to moderate dehydration. Infalyte showed greater sodium absorption in the first 24 hours.
Area of Science:
- Pediatrics
- Gastroenterology
- Clinical Nutrition
Background:
- Acute diarrhea is a common cause of dehydration in infants.
- Oral rehydration solutions (ORS) are the standard treatment for mild to moderate dehydration.
- Two commonly used ORS in the US are glucose-based (Pedialyte) and rice syrup solids-based (Infalyte).
Purpose of the Study:
- To compare the efficacy of Pedialyte and Infalyte in rehydrating infants with mild to moderate dehydration.
- To assess fluid, sodium, and potassium absorption and retention between the two ORS groups.
Main Methods:
- A double-blind, randomized study involving 60 infant boys (≤ 2 years old) with mild to moderate dehydration.
- Infants received either a glucose-based ORS (Pedialyte) or a rice syrup solids-based ORS (Infalyte).
- Clinical outcomes, intake, output, and absorption/retention of electrolytes were measured.
Main Results:
- Both ORS effectively rehydrated all infants without the need for intravenous fluids.
- No significant differences were observed in time to rehydration, weight gain, ORS consumption, or stool output.
- Infalyte demonstrated greater apparent sodium absorption compared to Pedialyte within the first 24 hours.
Conclusions:
- Both Pedialyte and Infalyte are effective oral rehydration solutions for infants with mild to moderate dehydration.
- The study suggests potential benefits of using a single ORS for both rehydration and maintenance phases.
- Further research could explore the long-term acceptance and efficacy of single-solution strategies in clinical practice.
Objective:
To compare the efficacy of two commonly used solutions in the rehydration of infants with mild to moderate dehydration caused by acute diarrhea in the United States.
Design And Setting:
Double-blind, parallel-group, randomized study performed at Children's Hospital Medical Center.
Patients:
Sixty infant boys (< or = 2 years old), with mild (< or = 5%) or moderate (6 to 9%) dehydration caused by acute diarrhea of less than 1 week's duration were included in the study.
Interventions:
Infants were randomly assigned to receive treatment with either a glucose-based oral rehydration solution (ORS) (Pedialyte, Ross Laboratories, Columbus, OH) or a rice syrup solids-based ORS (Infalyte, Mead Johnson Nutritional Group, Evansville, IN). After rehydration was achieved, patients entered a maintenance phase during which, in addition to a maintenance ORS, breast milk or a soy-based formula was offered; infants older than 1 year were also given a lactose-free diet.
Outcome Measures:
Rehydration was judged clinically. Infants remained on a metabolic bed during the study in to separate and quantitate urine and stool output. Therefore, in addition to clinical outcome, we compared intake, output and apparent absorption and retention of fluid, sodium, and potassium between groups.
Results:
All patients were successfully rehydrated using an ORS without the use of intravenous fluids. No differences were detected between treatment groups in time to rehydration, percentage of weight gain after rehydration, consumption of ORS to achieve rehydration, or stool output. However, the apparent sodium absorption (net intake less fecal output) was greater in the Infalyte group than the Pedialyte group during the first 24 hours.
Conclusion:
The two maintenance oral electrolyte solutions (Pedialyte and Infalyte) most commonly used in the United States are effective as rehydration solutions for infants with mild to moderate dehydration. We speculate that a strategy for oral rehydration therapy in the United States, based on the use of a single solution during the rehydration and maintenance phase, might gain additional acceptance by practicing pediatricians and family physicians.