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A double-blind clinical trial comparing World Health Organization oral rehydration solution with a reduced osmolarity solution containing equal amounts of sodium and glucose.
Santosham, M; Fayad, I; Abu Zikri, M; Hussein, A; Amponsah, A; Duggan, C; Hashem, M; el Sady, N; Abu Zikri, M; Fontaine, O.
Afiliação
  • Santosham M; Department of International Health, Center for American Indian and Alaskan Native Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland, USA.
J Pediatr ; 128(1): 45-51, 1996 Jan.
Article em En | MEDLINE | ID: mdl-8551420
ABSTRACT
PIP: Between July 1993 and March 1994, clinical researchers in Egypt enrolled 190 male children aged 1-24 months with acute diarrhea at the Abu El Reeche Hospital in Cairo in a randomized double-blind clinical trial to evaluate the relative efficacy of a reduced osmolarity oral rehydration solution (ORS) containing 75 mmol/l of both sodium and glucose (total osmolarity, 245 vs. 311 mmol/l for the standard ORS recommended by the World Health Organization and UNICEF) for treating acute noncholera diarrhea. They measured intake and output every three hours. Over the entire course of the study, the mean stool output was significantly lower in the reduced osmolarity ORS group than the standard ORS group (4.3 vs. 5 g/kg/hour; p 0.05). During the rehydration phase, the mean stool output was 36% lower in the reduced osmolarity ORS group than in the standard ORS group (p 0.05). The proportion of children vomiting during rehydration was much lower in the reduced osmolarity ORS group than the standard ORS group (17% vs. 33%; relative risk [RR] = 2.4; p 0.01). During the maintenance phase, the two groups shared similar stool output, mean intake of food and ORS, duration of diarrhea, and weight gain. Treatment failure was significantly more common in the standard ORS group than the reduced osmolarity ORS group (8% vs. 1%; RR = 7.9; p 0.01). The mean serum sodium level at 24 hours were much lower in the reduced osmolarity ORS group (134 vs. 138 mEq/l; p 0.001) but remained within the normal range in both groups. Children in both groups developed hyponatremia or their hyponatremia worsened at the same rate. Urine output was about the same in both groups. These findings suggest that the reduced osmolarity ORS has advantages over the standard ORS as a treatment for acute noncholera diarrhea. This safe and effective rehydration treatment reduces stool output and vomiting during rehydration as well as reduces the need for supplemental intravenous therapy.
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Sódio / Soluções para Reidratação / Diarreia Infantil / Hidratação / Glucose Tipo de estudo: Clinical_trials / Etiology_studies / Risk_factors_studies Limite: Humans / Infant / Male País/Região como assunto: Africa Idioma: En Revista: J Pediatr Ano de publicação: 1996 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Sódio / Soluções para Reidratação / Diarreia Infantil / Hidratação / Glucose Tipo de estudo: Clinical_trials / Etiology_studies / Risk_factors_studies Limite: Humans / Infant / Male País/Região como assunto: Africa Idioma: En Revista: J Pediatr Ano de publicação: 1996 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos