Oral Rehydration Therapy in Young Infants less than 3 Months with Acute Diarrhoea and Modeate Dehydration

Oral rehydration therapy (ORT) as an appropriate technology in the treatment of acute diarrhoeal diseases (ADD) has been accepted throughout the world. It has been proved that besides lifesaving, ORT has reduced about 70-80% of the use of intravenous solution and average cost of the treatment of ADD. If there is still problem, question or doubtfulness, is the use of WHO ORS in full concentration for the neonates and young infants less than 3 months of age. During one-year period it has been treated 72 cases of ADD in young infants less than 3 months of age with moderate dehydration. They were divided into 3 groups. The first group was treated with 100 mil kg bw of fluid consisting oftwothirds as WHO ORS in full concentration for 4 hours period and the rest, one-third, was given as plain water for 2 hours period. The second group was treated with kristalyte with the Na concentration of 51 mEq/L and the third group was treated with intravenous Ringer's lactate for 6 hours period. After the end of the study only 18 patients in each group could be matched and evaluated. From clinical observation and laboratory examinations, the result of the treatment in general, statistically shows no significant difference. Diarrhoea and vomiting stopped in all groups on the second day of treatment. Hyponatremia which occurred in 3 patients in Group I and 2 patients each in Group II and III improved after 6 hours of treatment. Acidosis was corrected in all of the treatment groups in 6 hours period. Weight gain up to 6-9% of body weight on admission was achieved after 6 hours of treatment in all groups. No complication of hypernatremia, convulsion nor hypoglycaemia in all the treatment group. From this study it could be concluded that WHO ORS is quite safe and effective as ORS with low sodium concentration and intravenous treatment, as far as it is given slowly, little by little with a strict supervision.

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Salt and Water Homeostasis during Oral Rehydration Therapy in Neonates and Young Infants with Acute Diarrhoea.

Acta Paediatrica ◽

10.1111/j.1651-2227.1988.tb10594.x ◽

1988 ◽

Vol 77 (1) ◽

pp. 37-41 ◽

Cited By ~ 4

Author(s):

L. MARIN ◽

S. SÖKÜCÜ ◽

H. GÜNOZ ◽

G. SANÉR ◽

O. NEYZI ◽

...

Keyword(s):

Acute Diarrhoea ◽

Oral Rehydration Therapy ◽

Water Homeostasis ◽

Oral Rehydration ◽

Young Infants

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Comparison between 200 ml and 1 liter packages of oral rehydration solution prepared by mothers of patients with diarrhea in the oral rehydration room

Paediatrica Indonesiana ◽

10.14238/pi28.11-12.1988.231-7 ◽

2019 ◽

Vol 28 (11-12) ◽

pp. 231-7

Author(s):

Muhammad Suryanto ◽

Renny Hariati ◽

Yati Soenarto ◽

Moenginah P. A.

Keyword(s):

Oral Rehydration Solution ◽

Sodium Concentration ◽

Children Under Five ◽

Oral Rehydration ◽

Under Five ◽

Group I ◽

Significant Difference ◽

Rehydration Solution ◽

Group Ii ◽

Hospital Group

To have a comparison between the preparation of oral rehydration solution (ORS) of 200 ml and 1 liter packages, a study had been done in 30 mothers of children under five years of age suffering from diarrhea who treated their children in oral rehydration room (group I) and 30 mothers of non diarrheal children under five years sampled in the out-patient Department of Child Health, Dr. Sardjito General Hospital (group II). No significant difference was found (p <0.05) concerning the sodium concentration in th ORS of 200 ml and in the 1 liter package (group I: 85.95 ± 16.07, and 81.52 ± 16.21, group II 98.11 ± 24.67 and 97.02 ± 21.87) (mEq/L, Mean ± SD). Of 30 mothers group 11, 5 mothers (19.23%) made mistakes in preparing the I liter packages of ORS and the sodium concentration in this package was higher compared to the concentration in the 200 ml package. There was no significant difference concerning diluted volume and the sodium concentration between group I and the recommended method, but there was a significant difference (p < 0.005) between group II and recommended method. A significant difference was also found (p ( 0.001) between group I and group 11 about the mothers knowledge of the effect of diarrhea, the use of ORS, the amount of ORS that must be given lo !he patients and !he indications to refer the patients to !he health center or hospital.

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Evaluation of mothers' knowledge about oral rehydration therapy and sodium concentration in homemade sugar salt solutions

Jornal de Pediatria ◽

10.2223/jped.353 ◽

2001 ◽

Vol 77 (6) ◽

pp. 481-6

Author(s):

Lauro Virgílio de Sena ◽

Helcio de S. Maranhão ◽

Mauro B. Morais

Keyword(s):

Oral Rehydration Therapy ◽

Sodium Concentration ◽

Salt Solutions ◽

Oral Rehydration

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Issues and Controversies in the Evolution of Oral Rehydration Therapy (ORT)

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6010034 ◽

2021 ◽

Vol 6 (1) ◽

pp. 34

Author(s):

David Nalin

Keyword(s):

Pediatric Patients ◽

Oral Rehydration Therapy ◽

Sodium Balance ◽

Plain Water ◽

Oral Glucose ◽

Oral Rehydration ◽

Low Sodium ◽

Current Review ◽

The Subject ◽

Rehydration Solution

The original studies demonstrating the efficacy of oral glucose-electrolytes solutions in reducing or eliminating the need for intravenous therapy to correct dehydration caused by acute watery diarrheas (AWD) were focused chiefly on cholera patients. Later research adapted the oral therapy (ORT) methodology for treatment of non-cholera AWDs including for pediatric patients. These adaptations included the 2:1 regimen using 2 parts of the original WHO oral rehydration solution (ORS) formulation followed by 1 part additional plain water, and a “low sodium” packet formulation with similar average electrolyte and glucose concentrations when dissolved in the recommended volume of water. The programmatic desire for a single ORS packet formulation has led to controversy over use of the “low sodium” formulations to treat cholera patients. This is the subject of the current review, with the conclusion that use of the low-sodium ORS to treat cholera patients leads to negative sodium balance, leading to hyponatremia and, in severe cases, particularly in pediatric cholera, to seizures and other complications of sodium depletion. Therefore it is recommended that two separate ORS packet formulations be used, one for cholera therapy and the other for non-cholera pediatric AWD.

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Efficacy of Probiotic Saccharomyces boulardii as an Adjuvant Therapy in Acute Childhood Diarrhoea

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v36i3.15539 ◽

2017 ◽

Vol 36 (3) ◽

pp. 250-255 ◽

Cited By ~ 5

Author(s):

Dillip Kumar Dash ◽

Mrutunjaya Dash ◽

M.D. Mohanty ◽

Naresh Acharya

Keyword(s):

Hospital Stay ◽

Tertiary Care ◽

Acute Diarrhoea ◽

Oral Rehydration Therapy ◽

Saccharomyces Boulardii ◽

Care Hospital ◽

Oral Rehydration ◽

Group 2 ◽

A Prospective Study ◽

Group 1

Introduction: Administration of S. boulardii in addition to rehydration therapy in diarrhea found to be beneficial in many aspects owing to a variety of causes and importantly it is was not associated with any adverse effects.Material and Methods: We conducted a prospective study of children suffering from acute diarrhoea, at a private tertiary care hospital. Children were divided into 2 groups randomly as per odd(Group 1 ) and even (Group 2) bed allotted in indoor at the time of admission: Group 1 included children on oral rehydration therapy (ORT) + Zinc + Saccharomyces boulardii (Probiotic 5 billion CFU twice daily) and Group 2 comprised of children on ORT+ Zinc. Our objective was to systematically review data on the effect of S. boulardii on acute childhood diarrhoea.Results: Out of a total of 126 children less than 2 years, 2-6 years and 6-14 years were 72 (57.14%), 42(33.33%) and 12(09.52%) respectively. The duration of diarrhoea in Group 1 was 26.31 hours and Group 2 was 47.81 hours (p<0.01). The frequency of diarrhoea showed improvement within 24 and 72 hours in Group 1 and Group 2 respectively (p<0.01).Similarly, the mean duration of hospital stay was 2.68 days in Group 1 and 4.8 days in Group 2.The treatment cost was INR 850 and INR 1650 while social cost was INR 1250 and 2600 in Group 1 and 2 respectively.Conclusion:This study shows that S. boulardii reduced the duration, frequency and hospital stay of diarrhoea thereby reducing the treatment and social costs.J Nepal Paediatr Soc 2016;36(3):250-255

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Hypernatraemia, acute diarrhoea, and oral rehydration therapy

The Lancet ◽

10.1016/0140-6736(92)90982-9 ◽

1992 ◽

Vol 339 (8798) ◽

pp. 936

Author(s):

M.J.G. Farthing

Keyword(s):

Acute Diarrhoea ◽

Oral Rehydration Therapy ◽

Oral Rehydration

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Rice based oral rehydration therapy in acute diarrhoea: a superior therapy and a medium for calorie supplementation

Child Health in the Tropics ◽

10.1007/978-94-009-5012-2_7 ◽

1985 ◽

pp. 65-70

Author(s):

A. M. Molla ◽

S. A. Sarker ◽

A. Molla ◽

M. Khatoon ◽

W. B. Greenough

Keyword(s):

Acute Diarrhoea ◽

Oral Rehydration Therapy ◽

Oral Rehydration

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Additive effect of resistant starch on oral rehydration therapy and zinc supplementation for children with acute diarrhoea

http://isrctn.org/> ◽

10.1186/isrctn06298820 ◽

2012 ◽

Author(s):

B S Ramakrishna

Keyword(s):

Resistant Starch ◽

Zinc Supplementation ◽

Acute Diarrhoea ◽

Oral Rehydration Therapy ◽

Additive Effect ◽

Oral Rehydration

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Efficacy of Glucose-based Oral Rehydration Therapy

PEDIATRICS ◽

10.1542/peds.98.1.45 ◽

1996 ◽

Vol 98 (1) ◽

pp. 45-51 ◽

Cited By ~ 3

Author(s):

Norma Gavin ◽

Nancy Merrick ◽

Bruce Davidson

Keyword(s):

Failure Rate ◽

Trial Type ◽

Pediatric Patients ◽

Oral Rehydration Therapy ◽

Sodium Content ◽

Supporting Evidence ◽

Failure Rates ◽

Safety And Efficacy ◽

Oral Rehydration ◽

Significant Difference

Objective. This article reviews and synthesizes evidence in the published literature on the safety and efficacy of oral rehydration therapy (ORT) among young children with pediatric gastroenteritis in developed nations. Methodology. We searched the literature for randomized, controlled trials comparing the safety and efficacy of ORT with intravenous (IV) rehydration treatment and/or oral rehydration solutions (ORSs) of different sodium content. We combined the failure rates of each set of studies in statistical meta-analyses and conducted tests of homogeneity of treatment effect over all the studies and for subgroups of children defined by the trial type, the sodium content of the ORS, and the setting of care. We also conducted a multivariate logistic regression on the probability of failure to determine the relative importance of these factors, controlling for other characteristics of the trials. Other outcomes were also tabulated and discussed. These include the relative incidence of hypernatremia and hyponatremia induced by treatment; weight gain; the volume, frequency, and duration of diarrhea; for inpatient trials, the length of stay; and for outpatient trials, rates of hospitalization. Results. The evidence suggests that among pediatric patients with gastroenteritis in developed countries, failure of ORT, defined as the need to rehydrate children intravenously, is infrequent. We found a combined overall ORT failure rate of 3.6%. We found no statistically significant difference in failure rates by trial type or the sodium content of the ORS. However, we did find some supporting evidence for a lower failure rate among children treated in outpatient settings. In addition, compared with patients rehydrated intravenously, pediatric patients treated with ORT were not found to be at higher risk of iatrogenic hypernatremia or hyponatremia. The evidence from the literature fails to show a consistent trend in favor of either high-or low-sodium solutions for rehydration of pediatric patients. Conclusions. There seems to be a great potential for improving the medical treatment of children with acute gastroenteritis by the greater use of ORT.

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