Controlled trial of hypo-osmalar versus World Health Organization oral rehydration solution.

Abstract

OBJECTIVE:

To compare the safety and efficacy of a hyposmolar oral rehydration solution (H-ORS) (245 mmol/liter) with the World Health Organization oral rehydration solution (WHO ORS) in cholera and acute non-cholera diarrhea.

DESIGN:

Controlled clinical trial.

SETTING:

Diarrhea training and treatment unit.

METHODS:

Thirty-five culture proven cholera and 135 acute non-cholera diarrheal patients randomly received H-ORS or WHO-ORS. Intake and output were measured every 4 hours.

RESULTS:

Analysis of the total cases revealed rehydration phase (p=0.048, 95% CI 0.64-0.99) and overall (p=0.046, 95% CI 0.70-0.99) frequency of stools to be significantly less in the H-ORS group. In the severely malnourished, the rehydration phase (p=0.032, 95% CI 0.55-97), maintenance phase (p=0.035, 95% CI 0.51-0.97) and overall (p=0.011; 0.95% CI 0.55-0.93) stool frequency were significantly decreased in the H-ORS group. The amount of ORS consumed in the maintenance phase of the cholera cases was significantly (p=0.04, 95% CI 0.44-0.98) less in the H-ORS group. All other parameters, despite showing a decreasing trend, were statistically comparable in the cholera, non-cholera and total cases. The amount of intravenous fluid needed was significantly more in the noncholera and total cases on H-ORS. In the non-breastfed cases, under two years of age, the total duration of diarrhea was significantly decreased (p=0.03; 95% CI 11.07-11.45) but the need for intravenous fluids significantly increased (p=0.02; 95% CI 109.8-112.1) in the H-ORS group. The proportion of children vomiting, the weight gain, urine passed in 24 hours, serum sodium, caloric intake and failure rate were comparable.

CONCLUSIONS:

H-ORS is as safe and effective as the WHO-ORS and may have some additional benefits in malnourished children.

• Authors: S Alam, K Afzal, M Maheshwari, I Shukla
• Journal: Indian pediatrics (Indian Pediatr) Vol. 37 Issue 9 Pg. 952-60 (Sep 2000) ISSN: 0019-6061 [Print] India
• PMID: 10992331 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Hypotonic Solutions
• Rehydration Solutions

Topics

• Administration, Oral
• Child, Preschool
• Cholera (diagnosis, therapy)
• Confidence Intervals
• Diarrhea (microbiology, therapy)
• Female
• Fluid Therapy (methods)
• Follow-Up Studies
• Humans
• Hypotonic Solutions
• India
• Infant
• Male
• Osmolar Concentration
• Probability
• Rehydration Solutions (administration & dosage, standards)
• Treatment Outcome
• World Health Organization