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Safety and efficacy of three oral rehydration solutions for children with diarrhoea (Edinburgh 1984-85).

Of 357 children with acute diarrhoea admitted to the City Hospital, Edinburgh, over a 12-month period, only 5 (1.4%) required IV infusions. Three hundred and nineteen were treated with oral rehydration (OR). Of these 269 were studied in detail and 43% had signs of dehydration, but in none of them was it severe. There were no fatalities. Patients were randomly allocated to treatment with one of three OR solutions in a double blind trial. The solutions had sodium concentrations of 35, 50 and 90 mmol (mEq)/l, and dextrose of 200 (36 g/l), 111 (20 g/l) and 110 (19.8 g/l) mmol/l, respectively. Hypernatraemia was not a clinical problem and only 5 children (2%) were biochemically hypernatraemic on admission. Treatment did not cause clinical hypernatraemia. At the second assessment only 3 children were biochemically hypernatraemic, one from each treatment group, and no one had clinical signs. All three solutions were safe and effective in the relatively mildly dehydrated patients currently seen in the UK.

Child↗

Uncooked rice powder in oral rehydration solution: an alternative to glucose or cooked rice powder.

Glucose-based or rice-based ORS is the standard treatment in acute dehydrating diarrhoea. However, glucose may not be easily available in remote villages and the rice needs to be cooked for rice-based ORS. We embarked on a study to examine whether uncooked rice powder could be used as an alternative to glucose or cooked rice powder in ORS. Initially, 50 adult male patients (aged 18 to 55 yr) were randomized to receive glucose-ORS or uncooked rice ORS, in two equal groups. Subsequently, 20 male children (aged 3 to 12 yr) were also enrolled in the study and received either WHO-ORS or study ORS. All the adult patients and the children could be successfully rehydrated with ORS containing uncooked rice powder. As compared to WHO-ORS, the study ORS significantly reduced stool output (6.60 +/- 1.24 vs. 5.88 +/- 1.34 l), ORS intake (9.17 +/- 1.54 vs 8.24 +/- 1.69 l) and duration of diarrhoea (45.68 +/- 6.91 vs 41.32 +/- 6.03 h). In children also similar results were obtained. No clinical complication (e.g., vomiting, abdominal pain etc.) or abnormality in serum electrolyte concentrations was encountered either in the adults or in the children. Uncooked rice powder containing ORS can be considered as an alternative to glucose-based ORS or rice-based ORS.

Adolescent↗