Oral Glucose-Electrolyte Solutions as Maintenance Therapy of Acute Diarrhea

Safety and Effectiveness of Homemade and Reconstituted Packet Cereal-based Oral Rehydration Solutions: A Randomized Clinical Trial

“…Nonetheless, treatment failure rates were similarly low for the three treatment groups and within the range of failure rates reported in other trials of outpatient ORT in the United States. [27][28][29][30][31][32] The three solutions studied were found to be equally effective in maintaining hydration and correcting both hypernatremia and hyponatremia. We did not find any advantage in treatment outcome among children in the CBORS groups compared with those assigned glucose-based ORS.…”

Optimising Oral Rehydration Solution Composition for the Children of Europe: Clinical Trials

“…Most of the solutions commercially available in Europe and in the United States have glucose concentrations at the top of the range, containing between 200 and 280 mmolil (9,12,13,(24)(25)(26)(27). Solutions with high carbohydrate concentrations were generally designed to improve caloric intake and taste, as occurred in ORS designed prior to the discovery of glucose-sodium coupled transport mechanism (21,281, or merely to render solutions ioosmotic, with no consideration for the risk of osmotic diarrhoea (12,29,30) and of hypernatraernia (24). Glucose content of WHO-ORS (111 mmolil) was set to promote maximum uptake of sodium and water and to avoid the osmotic influence of any unabsorbed glucose (3 l), and is thus more appropriate than the higher concentrations present in many commercially available solutions.…”

“…Reported complications related to the sodium concentration of ORS containing 30-65 mmolil sodium in 17 clinical trials include the following: (i) asymptomatic hyponatraemia is referred to in 5 of 17 clinical trials, but in most cases it affected less than 10% of the patients (10,13,27,60,61); (ii) periorbital oedema is mentioned in reports of 2 clinical trials occurring in one patient (4%) receiving an ORS with 60 mmol/l sodium in one trial (26) and in 15 ' % of the patients receiving ORS with 50 mmolil sodium, in another trial, in this instance being unrelated to hypernatraemia (59). The worsening of the diarrhoea associated with low sodium ORS (29) has been attributed to the high carbohydrate content rather than to the sodium concentration (12). Overall.…”