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Comprehending the use of oral rehydration therapy

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eMediNexus    08 December 2022

Diarrheal Fluid loss makes a significant cause of mortality among children under the age of 5. Oral rehydration therapy (ORT) remains a first‐line therapeutic measure to counterbalance the volume loss due to diarrhea and vomiting among gastroenteritis patients. Despite adequate knowledge, ORT is inadequately practiced, particularly in developing countries.

 

The present study provides several recommendations regarding using ORT to treat hypovolemia. It also conveys that the healthcare centers and professionals have restricted information regarding its adequate usage.

 

The study suggests that-

 

Home-based care is suitable in mild to moderate water loss (3%–9% volume reduction), including oral fluid replacement techniques. It can be divided into the Rehydration and Maintenance phase, where ORS of 50 to 100 ml/kg is given every four h. Giving extra ORS can replace the ongoing loss of the digestive system (stool or vomiting). After completing the replacement phase, the patient should start nutrition and fluids, and the ORT can be continued for continuous gastrointestinal excretion. 

 

In severe dehydration (volume loss of >10%), IV treatment with a rapid administration of 20 ml/kg body weight with isotonic saline is needed. When the patient′s clinical status and level of consciousness stabilizes, they can be switched to ORS. A nasal tube can be used in patients with a normal mental state and inability to consume enough fluid. ORS is given in 100 ml/kg body weight volume at four h or 25ml/kg. After the completion of rehydration, nutrition and fluids should be started, and ORT should be continued to replace gastrointestinal excretion.

 

Despite various modifications to the therapy, it remains the first choice for treating volume depletion following diarrhea. In cases where ORT fails, IV rehydration should be commenced. These cost‐effective and easily available options can save several lives but are foregone due to incorrect understanding regarding the treatment of diarrhea. A clear and simple set of guidelines is warranted to fill the void between the knowledge and the practice of using ORT.

 

Aghsaeifard Z, Heidari G, Alizadeh R. Understanding the use of oral rehydration therapy: A narrative review from clinical practice to main recommendations. Health Sci Rep. 2022 Sep 11;5(5):e827. Doi: 10.1002/hsr2.827. PMID: 36110343; PMCID: PMC9464461.

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