Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Rehydration Solutions”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources

Can oral rehydration solution be safely flavored at home?

OBJECTIVE: To determine the concentration of sodium, potassium, glucose, and osmolality of oral rehydration solutions (ORS) which have been flavored with varying amounts of unsweetened Kool-Aid powder, Jell-O powder, apple juice, or orange juice. DESIGN: Descriptive. SETTING: Alberta Children's Hospital Chemistry Laboratory. PATIENTS: None. INTERVENTIONS: Addition of varying amounts of flavoring easily available in all households to commercially available unsweetened ORS. MAIN OUTCOME MEASURES: Concentrations of electrolytes, glucose, and osmolality. RESULTS: Addition of fruit juices or flavor powders to commercially produced ORS does alter the electrolyte content and osmolality. When limited amounts of flavoring or juice is added, the osmolality of the solution approaches iso-osmolality. CONCLUSIONS: Small amounts of unsweetened Kool-Aid powder, Jell-O powder, and apple or orange juice can be added to oral rehydration solutions without significantly altering electrolyte composition and osmolality.

Beverages↗

Effects of an isotonic oral rehydration solution, enriched with glutamine, on fluid and sodium absorption in patients with a short-bowel.

AIM: To compare the effects of a standard oral rehydration solution with a polymeric glucose isotonic solution enriched with glutamine on water and sodium absorption in the short bowel. METHODS: Six patients with high jejunostomy were tested in a random order on 2 consecutive days with the standard solution (20 g/L glucose, 94 mmol/L sodium, 292 mOsm/kg osmolality) and a solution containing maltodextrins (18 g/L Glucidex 12; hydrolysis of 18 g of Glucidex 12 yields 20 g glucose) enriched with 14.6 g/L of glutamine (94 mmol/L sodium, 282 mOsm/kg osmolality). Solutions were administered via a naso-gastric tube at a rate of 2 mL/min. Jejunal effluent for each solution was collected during an 8-h period, after a 14-h equilibrium period. RESULTS: The net 8-h fluid absorption was not significantly different between the standard solution and the solution with glutamine (333 +/- 195 and 213 +/- 251 mL, respectively (mean +/- S.E.M.)). Net sodium absorption was higher for the standard solution than for the solution with glutamine (15 +/- 15 vs. 2 +/- 20 mmol, P < 0.05). The rate of glucose absorption was not different between the solutions. CONCLUSION: The replacement of glucose by maltodextrins and the addition of glutamine to the standard oral rehydration solution, without changing its sodium content or osmolality, results in a reduction of sodium absorption in the short-bowel syndrome.

Adult↗

Glycine, glycyl-glycine and maltodextrin based oral rehydration solution. Assessment of efficacy and safety in comparison to standard ORS.

We evaluated the efficacy and safety of an oral rehydration solution containing glycyl-glycine, glycine, and maltodextrin (GGG-ORS), in comparison to the glucose based ORS (standard ORS). The osmolality of the GGG-ORS (305 mOsm/l) and standard ORS (311 mOsm/l) was similar. Ninety-two children presenting with acute gastroenteritis and moderate dehydration, aged 3 months to 3 years, were randomly assigned to receive standard ORS or GGG-ORS. All the patients were successfully rehydrated orally. The two groups were comparable for baseline characteristics including the microbial etiology. Rotavirus (49%, 36%), ETEC (11%, 18%) or a combination of rotavirus and ETEC (15%, 9%) were the main stool pathogens isolated. There was no significant difference in the mean stool output or duration of diarrhoea between the two groups. Patients in the GGG-ORS group had higher urine output (p less than 0.01) and weight gain (p less than 0.05) in the initial 6 hours when feeding was withheld, but no such differences were observed beyond this period. Hypernatremia did not develop in any patient during the study. We conclude that glycine and glycyl-glycine supplemented oral rehydration solution does not have any therapeutic advantage in the treatment of acute gastroenteritis with moderate dehydration caused predominantly by rotavirus.

Acute Disease↗

Glycine-based oral rehydration solution: reassessment of safety and efficacy.

We evaluated the safety and efficacy of a glycine-based orally administered rehydration solution by comparing it with a standard oral rehydration solution (ORS) without glycine in a randomized double-blind trial in United States infants (age less than 15 months) given treatment for acute gastroenteritis as inpatients or outpatients. The response to therapy (stool volume and duration of illness) was similar in the two groups, except that in four (13%) of 31 hospitalized infants receiving glycine-ORS hypernatremia developed, (one had symptoms) compared with none of 35 receiving ORS (P less than 0.04). Among the 77 outpatients there were no differences between the groups. This study demonstrates that glycine-ORS did not provide any therapeutic advantage over standard ORS, and hypernatremia developed in some patients receiving glycine-ORS. We suggest that caution be used with this type of solution until further safety studies have been done.

Anti-Bacterial Agents↗

[Biochemical composition of oral rehydration solutions and their combinations suggested for use in Venezuela].

We studied the electrolyte composition, pH and osmolality of six solutions for oral rehydration available in drug stores in Venezuela, and also their combinations with whole milk in a dilution of 6.6%. The solutions such as Pedialyte, Hidramilac and Hidramines showed an acid pH (4.30-5.10) in direct relationship to the concentration of carbohydrates (5% or more). Also, Pedialyte and Hidramilac had greater osmolalities (360-365 mOsm/kg) than plasma. Some of the levels of sodium and potassium in the solutions were found to be under the concentrations given by the producers. The combination of whole milk with oral solutions diminishes the concentrations of sodium and potassium in the mixture, changing the sodium-glucose relationship, pH and osmolality. The therapeutic implications for the use of oral rehydration solutions with low concentrations of sodium, acid pH, large content of glucose and elevated osmolality are discussed. It is concluded that the combination of whole milk with Sueroral (WHO) is not adequate for the optimum absorption of sodium and therefore to prevent dehydration. Therefore, except for the WHO solution and Oralite, other solutions are not adequate for the correction of the electrolytic and acid-base alterations present in infants with dehydration secondary to acute diarrhea.

Chlorides↗

Comparison of the sodium contents of six commonly recommended oral rehydration solutions.

The sodium contents of six differently prepared oral rehydration solutions (ORS) were measured. A total of 452 solutions were prepared in our gastro-enteritis unit. The finger-pinch-and-cup method produced sodium values that were too high and too variable. The most acceptable sodium level was achieved using half a 5 ml medicine teaspoon or 1 level common household teaspoon of salt in 1 litre of water. Half a commonly available household teaspoon of salt caused sodium levels to be low but still acceptable and safe. We recommend that half a teaspoon of salt in 1 litre of water be used when preparing an ORS.

Fluid Therapy↗

Glucose vs sucrose in oral rehydration solutions for infants and young children with rotavirus-associated diarrhea.

The use of oral rehydration solutions containing essential electrolytes and either glucose or sucrose of equal osmolality was compared in a double-blind sequential trial of 784 children with rotavirus-associated diarrhea treated at a center in rural Bangladesh. The oral fluid failure rate was 11.5% for the sucrose-containing solution group and 7.3% for the glucose-containing group (P = NS). Vomiting was a significantly more common cause of failure for the group treated with sucrose-containing oral rehydration solution and was associated with an increased rate of intake of the sweeter sucrose-containing solution. The purging rate was not different for the two groups. The oral fluid failure rates for children in the most underweight category (less than 60% of expected weight for age) were not different from those for other groups, although, as assessed by purging rate and initial dehydration, the stool losses of members of this group constituted a greater proportion of their body weight. Glucose is the preferred carbohydrate for oral electrolyte solutions, although sucrose can be substituted with only minimum loss of efficacy.

Child, Preschool↗

Community-based randomized controlled trial of reduced osmolarity oral rehydration solution in acute childhood diarrhea.

OBJECTIVE: The standard oral rehydration solution (ORS) recommended by WHO and UNICEF does not reduce the volume or frequency of stools or the length of the episode. Hospital-based studies from developing and developed countries and intestinal perfusion studies suggest a beneficial effect on water and sodium absorption with reduced osmolarity ORS as compared with standard ORS. We conducted a community-based study comparing the efficacy of reduced osmolarity ORS (224 mmol/l) with standard ORS (311 mmol/l) in acute childhood diarrhea in a West African community. METHODS: Infants and toddlers age 0 to 30 months having 738 episodes of diarrhea identified by weekly household visits were randomly assigned to treatment with either standard ORS (n = 376) or reduced osmolarity ORS (n = 362). The children were followed by daily home visits to assess ORS intake and clinical characteristics. Duration of diarrhea was compared by proportional hazards regression analysis, the hazard ratio being interpreted as the relative recovery rate between the children receiving the two types of ORS. Because earlier reports have suggested that weaning status might be an important modifier for the performance of reduced osmolarity ORS, the effect was assessed overall and as an interaction between type of ORS and weaning status and age. Maternal satisfaction was assessed in a paired analysis among mothers whose children participated at least twice in the study. RESULTS: In the overall analysis reduced osmolarity ORS was as efficacious as standard ORS as assessed by duration of diarrheal episode and total number of stool evacuations on Days 1 and 2. Non-breast-fed toddlers (i.e. children ages 12 to 30 months) treated with reduced osmolarity ORS had significantly shorter diarrheal episodes [1.14 days vs. 1.78 days with standard ORS; hazard ratio, 1.50; 95% confidence interval (CI), 1.07 to 2.09] and lower total number of stool evacuations on Days 1 and 2 (3.9 stool evacuations vs. 5.0 stool evacuations with standard ORS; ratio of geometric means, 0.77; 95% CI 0.60 to 1.01). No significant difference was found for breast-fed toddlers or for infants. There was no statistically significant difference in the ORS intake between the two treatment groups. The odds ratio for the mother preferring reduced osmolarity ORS to standard ORS was 1.92 (95% CI 0.97 to 3.85). CONCLUSIONS: Reduced osmolarity ORS was as efficacious as standard ORS. Non-breast-fed children treated with reduced osmolarity ORS had significantly shorter diarrheal episodes and a tendency toward lower stool frequency. These findings may be of importance, especially in developing countries where early weaning is common.

Acute Disease↗

A packaged rice-based oral rehydration solution for acute diarrhea.

In a 12-month community study in Ecuadorian preschool children, we compared a packaged rice-based oral rehydration solution (R-ORS) that contained 160 g of rice flour and 12 g of sucrose per liter as well as electrolytes and alpha-amylase, and required cooking before consumption, to the standard glucose-electrolyte oral rehydration solution (G-ORS) for the treatment of acute noncholera diarrhea. The reconstituted R-ORS had energy and protein contents of 620 kcal/L and 12g/L, respectively, and an osmolarity of 230 mosm/L. In all, 156 cases were treated with the R-ORS and 144 with the standard G-ORS. Cases treated with R-ORS had a significantly shorter duration of diarrhea (p < 0.0001; median; 34 h versus 48 h), a lower number of stools (p < 0.001; median; four versus seven), and a greater weight gain after 4 days of treatment (p < 0.05; mean; 1.6% versus-0.2%) than those treated with G-ORS. ORS and total liquid intakes tended to be higher with the R-ORS. The two ORS were equivalent for the correction of mild dehydration and the maintenance of normal hydration status.

Acute Disease↗

Search for the ideal oral rehydration solution: studies in a model of secretory diarrhoea.

In situ perfusion of whole rat small intestine was used to compare the efficacy of five oral rehydration solutions in promoting water and sodium absorption in normal intestine and secreting intestine after exposure to cholera toxin. Solutions varied in their sodium (35-90 mmol/l) and glucose (111-200 mmol/l) concentrations, molar ratio of glucose:sodium (1.2-5.8), and osmolality (281-331 mOsmol/kg), and contained either bicarbonate (18-30 mmol/l) or citrate (10 mmol/l). In normal intestine all solutions promoted net water absorption. Cholera toxin induced reproducible water secretion but all solutions reversed this to absorption. Water absorption was greatest with solutions containing sodium 60 mmol/l and glucose 111 or 140 mmol/l, and with a glucose:sodium ratio approximately 2, in both normal and secreting intestine. All solutions promoted net glucose absorption in both normal and secreting intestine. Net sodium absorption occurred with solutions containing greater than or equal to 60 mmol/l sodium in normal intestine but sodium secretion occurred from all solutions in secreting intestine. Sodium movement was directly related to the sodium concentration of the solution and sodium secretion occurred despite net water and glucose absorption. We consider that these studies may guide future development of oral rehydration solutions.

Animals↗

Osmolality electrolyte and carbohydrate type and oral rehydration solutions: a controlled study to compare the efficacy of two commercially available solutions (osmolalities 240 mmol/L and 340 mmol/L).

An open-label, inpatient study was undertaken to compare the efficacy of two oral rehydration solutions (ORS) given randomly to children aged 1-10 years who had acute gastroenteritis with mild or moderate dehydration (n = 45). One solution contained 60 mmol/l sodium and 1.8% glucose, total osmolality 240 mosm/l (Gastrolyte, Rhone-poulenc, Rorer) and the other contained 26 mmol/l sodium, 2.7% glucose and 3.6% sucrose, total osmolality 340 mOsm/l (Glucolyte, Gilseal). Analysis of data indicated that Gastrolyte therapy resulted in significantly fewer episodes and volume of vomiting over all time periods in comparison to Glucolyte and significantly less stool volume during the first 8 h and in the 0-24 h period. The differences between treatments in degree of dehydration at each follow-up period, duration of diarrhoea, and duration of hospital stay were not significant. No adverse drug reactions occurred. Six patients received intravenous rehydration treatment and were considered treatment failures. We conclude that oral rehydration therapy is safe and efficacious in the management of dehydration in acute diarrhoea and that the lower osmolar rehydration solution has clinically marginal advantages.

Acute Disease↗

Glycine supplemented oral rehydration solutions for diarrhoea.

Two glycine supplemented oral rehydration solutions (ORS) and a standard ORS with sodium 60 mmol/l were compared for treatment of diarrhoeal dehydration in children. The solutions contained glycine 110 mmol/l and glucose 110 mmol/l (ORS60-Gly110), glycine 60 mmol/l and glucose 80 mmol/l (ORS60-Gly60), and glucose 144 mmol/l only (ORS60), respectively. The patients receiving ORS60-Gly110 had poor weight gain and increased stool and urine volumes after rehydration compared with the other two groups. The patients receiving ORS60-Gly60 had similar stool and urine volumes as those receiving standard ORS60. It is concluded that excess glycine in relation to sodium in an ORS may lead to osmotic diarrhoea, and a high amount of absorbed glycine may result in osmotic diuresis with poor net rehydration. Altogether, the present study failed to find any improvement ('Super-ORS') by addition of glycine to an ORS containing 60 mmol/l of sodium.

Child, Preschool↗

Efficacy comparison of oral rehydration solutions containing either 90 or 75 millimoles of sodium per liter.

In a randomized trial, 62 infants 2 to 35 months of age with dehydration due to acute watery diarrhea were allocated to one of two groups: group A received solution A (World Health Organization-recommended oral rehydration solution), which contained (mmol/L): Na+ 90, K+ 20, Cl- 80, citrate3- 10, and glucose 110; group B received solution B (Pedialyte RS; Abbott Laboratories, North Chicago), which contained (in mmol/L): Na+ 75, K+ 20, Cl- 65, citrate3- 10, and glucose 139. Oral therapy was given until clinical signs of hydration status were normal. During the 48-hour trial, the following laboratory data were collected: blood gases, serum electrolytes, glucose, urea, and creatinine values and sodium and potassium concentrations in stool and urine; serial weights and clinical signs were also reported. Six of the 62 infants, three in each group, required intravenous fluids because of high stool output. Results of clinical outcome and normalization of altered serum electrolyte values were similar in both groups. During the 48-hour trial, eight patients in group A and four in group B had mild, asymptomatic hypernatremia. Pedialyte RS was found to be a safe glucose/electrolyte solution for oral rehydration therapy.

Administration, Oral↗

Osmotic production of sterile oral rehydration solutions--an economic, low-technology method.

A sterile oral rehydration solution can be produced by immersing in water a semi-permeable cellulose tube containing glucose and salts. Osmotically-driven ultrafiltration excludes all microbes and particulate matter even when the immersion water contains 45 x 10(6) cfu/ml of Pseudomonas aeruginosa, 25 x 10(7) cfu/ml of Staphylococcus aureus or 20 x 10(7) cfu/ml of Escherichia coli. Solutions of consistent composition can be obtained by having a standard amount of glucose-electrolytes in a cellulose tube of appropriate dimensions and immersing this in a fixed volume of water for a minimum period of time. The method is simple, inexpensive, low-technology and requires no external source of power. It has potential for producing sterile solutions for injections and intravenous use in situations with very limited and simple resources, in emergencies and during natural disasters. Further studies are now needed to determine whether the method can be adapted to provide the large quantities of oral rehydration fluid needed in field conditions.

Humans↗

The World Health Organization oral rehydration solution in US pediatric practice: a randomized trial to evaluate parent satisfaction.

BACKGROUND: The World Health Organization's effective, inexpensive oral rehydration solution (WHO-ORS) is used worldwide, but rarely by US practitioners because, in part, of concerns about parent satisfaction. OBJECTIVE: To compare caretaker satisfaction with the WHO-ORS, a packet-based solution requiring preparation, with satisfaction with a commercially prepared oral rehydration solution (C-ORS), (Pedialyte; Ross Nutritionals, Columbus, Ohio). DESIGN AND METHODS: Randomized controlled trial in an urban pediatric clinic and a suburban family medicine clinic. Children aged 3 to 47 months treated as outpatients for diarrhea were randomized to receive either WHO-ORS or C-ORS. After 48 hours of use, caretakers completed a telephone interview measuring satisfaction with aspects of the solution. RESULTS: Of 97 families enrolled, 91 (94%) were available for follow-up interviews. The WHO-ORS and C-ORS groups were comparable at baseline in all respects, except that slightly more caretakers in the latter group had used the C-ORS for the current illness before study enrollment (P= .06). Caretakers in the WHO-ORS group had higher overall satisfaction, satisfaction with cost, willingness to purchase in the future, and to recommend use (P<.001 for all). Differences remained significant after controlling for prior use of the C-ORS. There was no difference in satisfaction with ease of administration (P=.90), appearance (P=.20), and effectiveness (P=.80). No adverse effects attributable to either study solution occurred. CONCLUSIONS: Caretakers who prepared and used the WHO-ORS were more satisfied with their solution than a comparable group who administered C-ORS. Fear of parental dissatisfaction need not be a barrier to use of the WHO-ORS in the United States.

Child, Preschool↗

Current controversies in oral rehydration solution formulation.

Although the importance of oral rehydration therapy for acute diarrhea is unquestioned, controversy remains about the preparation and formulation of the oral rehydration solutions (ORS). There is disagreement about whether the ORS should be homemade or commercially prepared, what constitutes the optimal sodium content, what base (if any) should be present in the ORS, and whether other nutrients can be substituted entirely or in part for glucose. These issues are discussed and recommendations for the ideal ORS are presented.

Fluid Therapy↗

High sodium rehydration solutions in well-nourished outpatients.

We studied the safety and efficacy of high-sodium oral rehydration solution in the out-patient management of children with diarrhea, with or without dehydration. We studied 68 outpatients with acute diarrhea; 32% had mild-to-moderate dehydration; the rest were not dehydrated. They were treated at home for 24 h with either high-sodium (90 mmol/l) or low-sodium (30 mmol/l) solution. None of the patients given high-sodium solution became hypernatremic. Of those patients who were dehydrated, 55% did not take enough fluid at home to repair their dehydration. We conclude that patients must be closely supervised for the initial rehydration period, but that high-sodium rehydration solutions can be safely given to outpatients for up to 24 hours.

Acute Disease↗

Randomised double blind study of hypotonic oral rehydration solution in diarrhoea.

A hypotonic (osmolality 224 mmol/l, sodium 60 mmol/l) oral rehydration solution (ORS) was compared with an isotonic high glucose ORS (osmolality 304 mmol/l, sodium 60 mmol/l) in children with acute diarrhoea in a randomised double blind study. The stool output and hence the mean consumption of ORS for maintenance hydration was less (p = 0.036) in patients receiving hypotonic (69 ml/kg) than isotonic (97 ml/kg) ORS. Hypotonic ORS was more effective in patients with rotavirus positive than with rotavirus negative diarrhoea.

Acute Disease↗