Abstract | OBJECTIVES: Assess the safety of rapid intravenous rehydration of severely malnourished children and compare the efficacy of 3 formulations of oral rehydration salts solutions. PATIENTS AND METHODS: A group of 175 severely malnourished children of either sex (weight/length <70% of National Center for Health Statistics median), ages 6 to 36 months with cholera, were randomly assigned to receive 1 of 3 oral rehydration solutions (ORSs): glucose- ORS (n=58), glucose- ORS plus 50 g/L of amylase- resistant starch (n=59), or rice- ORS (n=58). Severely dehydrated children at enrollment were administered 100 mL/kg of an intravenous solution for 4 to 6 hours before randomisation, and those with some dehydration were randomised on enrollment. The electrolytes of the 3 ORSs were identical. In acute and convalescence phases, treatment was similar other than the nature of the ORSs. RESULTS: Intravenous fluid (mean) administered to 149 study children was 103 mL/kg (95% confidence interval [CI] 96-109), and all were rehydrated within 6 hours. None of them developed overhydration or heart failure. During the first 24 hours, stool output (31%; 95% CI 14%-42%; P=0.004) and the ORS intake (26%; 95% CI 12%-37%; P=0.002) of children receiving rice- ORS were significantly less compared with children receiving glucose- ORS. The mean duration of diarrhoea in all children (66 hours; 95% CI 62-71), and time to attain 80% of median weight/length (7.15+/-2.81 days) were not different. CONCLUSIONS:
Dehydration in severely malnourished children can safely be corrected within 6 hours. All study ORSs were equally efficient in correcting dehydration. Rice- ORS significantly reduced the stool output and ORS intake, confirming previous reports.
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Authors | Nur H Alam, Sufia Islam, Samima Sattar, Shirajum Monira, Jehan-François Desjeux |
Journal | Journal of pediatric gastroenterology and nutrition
(J Pediatr Gastroenterol Nutr)
Vol. 48
Issue 3
Pg. 318-27
(Mar 2009)
ISSN: 1536-4801 [Electronic] United States |
PMID | 19274788
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Carbohydrates
- Rehydration Solutions
- Glucose
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Topics |
- Carbohydrates
(therapeutic use)
- Child, Preschool
- Cholera
(complications, therapy)
- Defecation
- Dehydration
(etiology, therapy)
- Diarrhea
(complications, therapy)
- Drug Administration Schedule
- Energy Intake
- Female
- Fluid Therapy
(methods)
- Glucose
(therapeutic use)
- Heart Failure
(prevention & control)
- Humans
- Infant
- Infusions, Intravenous
(adverse effects, methods)
- Male
- Malnutrition
(complications)
- Oryza
- Rehydration Solutions
(therapeutic use)
- Treatment Outcome
- Weight Gain
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