Oral electrolyte therapy for diarrhea in infants – Tips From Other Journals
Oral rehydration with glucose-based and electrolyte-based solutions is a simple and effective means of treating or preventing dehydration in infants and children with acute diarrhea. Glucose-based solutions are easily absorbed in the intestine but do not enhance the reabsorption of fluid secreted from the intestine and, therefore, do not lessen the severity of diarrhea. Recent studies indicate that rice-based solutions may ameliorate dehydration and decrease loss of diarrheal fluid. Some researchers also suggest that the addition of small carrier molecules, such as amino acids, may improve rehydration solutions. Pizarro and associates conducted a prospective, randomized, double-blind study to compare the safety and effectiveness of two rice-based rehydration solutions with that of a standard glucose-based solution in the management of acute diarrhea in infants.
The study included 86 male infants who were admitted to the hospital with mild to moderate dehydration due to acute diarrhea. The infants were between the ages of three and 18 months. Thirty infants received a rice-based electrolyte solution, and 27 infants received the same ricebased solution with added casein hydrolysate (an amino acid). Twenty-nine other infants received a standard glucose-based solution without rice or amino acid. Fluid intake, fecal and urine output, and absorption and retention of fluid, sodium and potassium were measured in all of the infants over a 48-hour period.
The infants receiving the rice-based solutions had lower fecal output than those receiving the glucose-based solution. Infants receiving the rice-based solution containing amino acid vomited more frequently than infants receiving the other solutions. Both groups of infants receiving a rice-based solution had greater absorption of fluid and potassium than the other group of infants. Sodium balances were similar among the groups, even though the rice-based formulations contained one-third less sodium than the glucose-based solution.
All three oral rehydration solutions were effective in the treatment of mild to moderate dehydration due to acute diarrhea. However, the study findings suggest that the rice-based solution, without the addition of casein hydrolysate, may be most suitable in the rehydration of infants with acute diarrhea. (New England Journal of Medicine, February 21, 1991, vol. 324, p. 517.)
COPYRIGHT 1991 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group