Mota-Hernández F, Gutiérrez-Camacho C, Cabrales-Martínez RG, Villa-Contreras S

Language: Spanish
References: 19
Page: 21-25
PDF size: 89.23 Kb.

ABSTRACT

Objective. To evaluate the safety and effectiveness of two oral rehydration techniques. Material and Methods. A randomized clinical trial was conducted at the oral rehydration unit of Hospital Infantil de Mexico “Federico Gomez”, between September 1998 and June 1999. Forty patients five-year old and younger children, dehydrated due to acute diarrhea, were given oral rehydration solution (ORS) ad libitum (AL group); another forty patients received ORS in fractionated doses (FD group). Clinical characteristics were similar in both groups. Results are presented as means, standard deviations and medians, according the distribution of simple and relative frequencies. Results. The mean stool output in the AL group was 11.0±7.5 g/kg/h; as compared to 7.1±7.4 in the FD group (p=0.03). ORS intake, rehydration time, and mean diuresis values were similar in both groups (p›0.05). Six patients in the AL group and five in the FD group had high stool output (›10 g/kg/h), that improved after administration of rice starch solution. One patient in the AL group and two in the FD group had persistent vomiting that improved with gastroclisis. No patient required intravenous rehydration. Conclusions. These results suggest that ORS administration ad libitum under supervision, is a technique as safe and effective as the fractionated doses technique, for the treatment of dehydrated children due to acute diarrhea.

REFERENCES

1. Anónimo. Water with sugar and salt. Lancet 1978;1: 300-302.

2. Diarrheal Diseases Control Program: Oral rehydration salts (ORS) formulation containing trisodium citrate. Ginebra: World Health Organization, 1984; WHO/CDD/SER/84.7.

3. Hirschhorn N. The treatment of acute diarrhea in children. An historical and physiological perspective. Am J Clin Nutr 1980;33:637-663.

4. Hirschhorn N, Cash RA, Woodward EW, Spivey GH. Oral fluid therapy of Apache children with acute infectious diarrhoea. Lancet 1972;2:15.

5. A manual for the treatment of diarrhea. For use by physicians and other senior health workers O Ginebra: World Health Organization, 1990; WHO/ CDD/SER/80.2. Rev 2.

6. Clemens ML. Comparison of simple sugar/salt versus glucose electrolyte oral rehydration solution in infant diarrhoea. J Trop Med Hyg 1981; 84:189-194.

7. Islam MR, Ahmed SM. Oral rehydration solution with and without bicarbonate. Arch Dis Child 1984;59:1072-1075.

8. Hirschhorn N, Kinzle JL, Sachem DB, Northrup RS, Taylor JC, Ahmad SL et al. Decrease in net stool output in cholera during intestinal perfusion with glucose containing solution. N Engl J Med 1968;279:176-181.

9. Velásquez-Jones L, Llausás-Magaña E, Mota-Hernández F, Quiroz RBB. Tratamiento ambulatorio del niño deshidratado por diarrea aguda. Bol Med Hosp Infant Mex 1985;42:220-225.

10. Herring AJ, Inglis NF, Ojeh CK, Snodgrass DR, Menzies JD. Rapid diagnosis of rotavirus infection by direct detection of viral nucleic acid in silver stained polyacrilamide gels. J Clin Microbiol 1982;16:473-477.

11. Winkel P, Statland BE. Teoría de los valores de referencia. En: Bernard HJ, Todd-Sanford-Davidsohn, ed. Diagnóstico y tratamiento clínicos por el laboratorio. 8ª ed. Barcelona: Salvat Editores, 1988:65-74.

12. Mota HF, Bross SD, Pérez RML, Velásquez JL. Rice solution and World Health Organization Solution by gastric infusion for high stool output diarrhea. AJDC 1991;145:937-940.

13. Brown G. Sample size. AJDC 1988;142:1213-1215.

14. Anaya CML, Guiscafré GH, Gutiérrez CC, Villa CS, Mota HF. Factores de riesgo asociados a deshidratación por diarrea aguda, después de recibir consulta pediátrica. Bol Med Hosp Infant Mex 2001;58:4-13.

15. Sladen EG, Dawson MA. Interrelationship between the absorption of glucose, sodium and water by the normal human jejunum. Clin Sci 1969;36:119-132.

16. Lifshitz F, Wapnit RA. Oral hydration solutions: Experimental optimization of water and sodium absorption. J Pediatr 1985;106:383-386.

17. Özmert E, Yurdakök K, Aslan D, Yalsin SS, Yardim M. Clinical characteristics of transient glucose intolerance during acute diarrhoea. Acta Paediatr 1999;88:1071-1073.

18. Ruuska T, Vesikari T. Rotavirus disease in Finnish children: Use of numerical scores for clinical severity of diarrhoeal episodes. Scand J Infect Dis 1990;22:259-267.

19. Fukuda JM, Yi A, Chaparro L, Campos M, Chea E. Clinical characteristics and risk factors for Vibrio cholerae infection in children. J Pediatr 1995;126:882-886.