A double-blind clinical trial comparing World Health Organization oral rehydration solution with a reduced osmolarity solution containing equal amounts of sodium and glucose

Santosham, Mathuram; Fayad, Ibrahim; Zikri, Maha Abu; Hussein, Abeer; Amponsah, Akwasi; Duggan, Christopher; Hashem, Mohamed; Sady, Nermine El; Zikri, Mona Abu; Fontaine, Olivier

doi:10.1016/s0022-3476(96)70426-2

Cited by 63 publications

(37 citation statements)

References 8 publications

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“…Hypotonic fluids with a sodium content of 45 -65 mmol/l (e.g. Rehidrat, Sorol) allow more rapid rehydration than fluids with a higher sodium content, 29 but hypertonic sugar-based drinks with little sodium (e.g. cola and sports drinks) may result in osmotic aggravation.…”

Section: Acute Gastroenteritis: What Are the Problems?mentioning

confidence: 99%

Management guidelines for acute infective diarrhoea / gastroenteritis in infants

Wittenberg

2012

S Afr Med J

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Section: Acute Gastroenteritis: What Are the Problems?mentioning

confidence: 99%

Management guidelines for acute infective diarrhoea / gastroenteritis in infants

Wittenberg

2012

S Afr Med J

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“…Maintaining the osmolarity at 245 mOsm/L is essential to facilitate Na ϩ absorption. In these studies, [11][12][13][14] patients who received ORS with reduced osmolarity may have had an increased risk for hyponatremia (defined as a serum Na ϩ concentration Ͻ130 mEq/L) after 24 hours of treatment, but this result was of no clinical significance. The incidence of vomiting in patients given reducedosmolarity (75 mEq/L Na ϩ , 75 mmol/L glucose, and a total osmolarity of 245 mOsm/L) ORS was significantly reduced (∼30%), but the incidence of hyponatremia did not differ significantly from that in the patients receiving standard ORS solution.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Three Oral Rehydration Strategies in the Treatment of Acute Diarrhea in a Tropical Country

Pignatelli¹,

Musumeci

2003

Current Therapeutic Research

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Background: The administration of hydrating solutions and early refeeding improve recovery for infants and children with diarrhea.Objective: The aim of this study was to assess the efficacy of a low-osmolarity (30 mEq/L Na ϩ ) solution administered after the standard, high-osmolarity (90 mEq/L Na ϩ ) solution via a nasogastric tube (NGT) and followed by early refeeding to achieve more rapid body weight recovery in infants and children with acute diarrhea.Methods: Infants and children aged Ͻ5 years with acute diarrhea and dehydration (body weight loss of Ն10%) observed from January to August 2001 at Saint Camille Medical Center, Ouagadougou, Burkina Faso, were enrolled. Patients were randomized to 1 of 3 treatment protocols. Patients in group A received, via NGT, rehydration with a high-osmolarity solution for 3 hours, followed by a low-osmolarity solution for at least 3 additional hours. Patients in group B were given only a low-osmolarity solution via NGT. In group C, rehydration was carried out using a high-osmolarity solution via NGT.Results: Four thousand consecutively treated infants and children (2010 boys, 1990 mean [SD] age, 3.5 [2.7] years) were enrolled. After the first 6 hours of infusion, 90% of the patients who had received the combined rehydration (group A) showed significant body weight recovery, versus 80% and 79% of the patients in groups B and C, respectively. Stool output significantly decreased for group A compared with groups B and C (114 vs 125 and 120 g/kg, respectively). Only 7% of the patients in group A required prolonged rehydration (Ͼ6 hours) with the low-osmolarity solution, versus 10% and 12% in groups B and C, respectively. A total of 3% of patients treated with combined rehydration required hospitalization, compared with 10% and 9% in groups B and C, respectively. At the end of infusion, 25% of the patients rehydrated only with a lowosmolarity solution showed poor body weight recovery and appeared lethargic, 189CURRENT THERAPEUTIC RESEARCH versus 10% in group A and 15% in group C. Patients who were rehydrated with a high-osmolarity solution showed symptoms of hypernatremia (serum Na ϩ concentration Ͼ140 mEq/L). At the end of rehydration (Ն6 hours), all patients recovered their previous body weight, partially or totally, and refeeding was begun. Rehydration and diet were continued at home, or in neighboring areas for those living far away. Conclusions:In this study population, the administration of a high-osmolarity solution followed by a low-osmolarity solution and early refeeding was effective in the treatment of acute diarrhea and was well tolerated. (Curr Ther Res Clin Exp. 2003;64:189-202)

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“…En el estudio multicéntrico (12) en el que se empleó una solución con 60 mmol/L de sodio, el riesgo de necesitar líquidos intravenosos fue mayor entre los niños que recibieron el SHO/90, aun cuando la diferencia no fue significativa, RR=1,4 (0,9-2,4). En el estudio de Santosham et al (14), que utilizó la misma solución empleada en el presente estudio, también se encontró un mayor riesgo de necesitar Cuadro 6. Comportamiento de diferentes parámetros durante el período de observación en cada uno de los grupos.…”

Section: Discussionunclassified

Hidratación oral con una solución de baja osmolaridad en niños deshidratados por enfermedades diarreicas: un estudio clínico controlado.

Bernal¹,

Velásquez²,

García³

et al. 2003

biomedica

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Se realizó un estudio clínico controlado para comparar la efectividad de un suero de baja osmolaridad (SBO) (245 mOsm/L), en relación con la solución de hidratación oral estándar recomendada por la OMS (SHO/OMS). El grupo 1 (69 niños) recibió el suero de hidratación oral, SHO/90 (311 mOsml/L) y el grupo 2 (71 niños) el suero de baja osmolaridad, SBO/75 (245 mOsm/L). La hidratación se consiguió con éxito en 88,4% en el grupo 1 y en 92,9% en el grupo 2 (p=0,35). El tiempo de hidratación fue 5,2 horas (DE=1,8) en el grupo 1 y 5,5 (DE=1,7) en grupo 2 (p=0,31). El gasto fecal fue 6,3 g/kg/hora (DE=5,0) en el grupo 1 y 5,6 g/kg/hora (DE=5,1) en el grupo 2 (p=0,94). El sodio al final de la hidratación fue 139,3 mEq/L (DE=7,1) en el grupo 1 y 136,7 mEq/L (DE=4,3) en el grupo 2 (p=0,014). El período de observación fue de 21 horas (DE=5,7) en el grupo 1 y de 22 horas (DE=5,6) en el grupo 2. El gasto fecal en el grupo 1 fue 5,2 g/kg/hora (DE=4,1) y 4,2 g/kg/hora (DE=4,1) en el grupo 2 (p=0,16). Necesitaron líquidos endovenosos 23,1% en el grupo 1 y 9,8% en el grupo 2 (p=0,033). La solución de baja osmolaridad tiene la ventaja de disminuir la necesidad de utilizar líquidos endovenosos, corrige la mayor parte de los trastornos del sodio plasmático en niños deshidratados y no produce riesgo de desarrollo de hiponatremia. Palabras clave: deshidratación, diarrea, diarrea infantil, rehidratación oral, soluciones para rehidratación, terapia con líquidos. Effectiveness of oral hydration therapy with a low osmolarity solution in children dehydrated by diarrhea A clinical trial was conducted to compare the efficacy of a low-osmolarity solution (245 mOsm/ L), and a standard oral rehydration solution (ORS) recommended by WHO for children dehydrated by diarrhea. Group 1 (69 children) received WHO/ORS (311 mOsml/L) and group 2 (71 children) received a low-osmolarity solution (245 mOsm/L). Rehydration was successful in 88.4% in group 1 and 92.9% in group 2 (p=0.35). Rehydration was completed in 5.2 h (SD +/-1.8) in group 1 and 5.5 (SD +/-1.7) in group 2 (p=0.31). Stool output was 6.3 g/kg/h (SD +/-5.0) in group 1 and 5.6 g/kg/h (SD +/-5.1) in group 2 (p=0.94). Sodium at rehydration-completion was 139.3 mEq/L (SD +/-7.1) in group 1 and 136.7 mEq/L (SD +/-4.3) in group 2 (p=0.014). Group 1 was under observation for 21 hours (SD +/-5.7) and group 2, for 22 hours (SD +/-5.6). Stool output in group 1 was 5.2 g/kg/h (SD 4.1) and 4.2 gr./kg/h (SD +/-4.1) in group 2 (p=0.16). In group 1, 23.1% required intravenous solutions and 9.8% in group 2 (p=0.03). In treating dehydrated children, the low-osmolarity solution diminished the need for intravenous solutions , corrected most plasmatic sodium disorders, and produced no-risk of developing hyponatremia.

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A double-blind clinical trial comparing World Health Organization oral rehydration solution with a reduced osmolarity solution containing equal amounts of sodium and glucose

Cited by 63 publications

References 8 publications

Management guidelines for acute infective diarrhoea / gastroenteritis in infants

Management guidelines for acute infective diarrhoea / gastroenteritis in infants

Comparison of Three Oral Rehydration Strategies in the Treatment of Acute Diarrhea in a Tropical Country

Hidratación oral con una solución de baja osmolaridad en niños deshidratados por enfermedades diarreicas: un estudio clínico controlado.

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