Sylvia Y Ofei1,2, George J Fuchs3,4. 1. Department of Pediatrics, University of Kentucky College of Medicine/Kentucky Children's Hospital, Lexington, USA. 2. Pediatric Gastroenterology, Hepatology, and Nutrition, University of Kentucky College of Medicine, 138 Leader Ave, Lexington, KY, 40506-9983, USA. 3. Department of Pediatrics, University of Kentucky College of Medicine/Kentucky Children's Hospital, Lexington, USA. george.fuchs@uky.edu. 4. Pediatric Gastroenterology, Hepatology, and Nutrition, University of Kentucky College of Medicine, 138 Leader Ave, Lexington, KY, 40506-9983, USA. george.fuchs@uky.edu.
Abstract
PURPOSE OF REVIEW: An understanding of fluid and electrolyte losses from diarrhea and mechanisms of solute cotransport led to development of oral rehydration solution (ORS), representing a watershed in efforts to reduce diarrheal disease morbidity and mortality. This report reviews the scientific rationale and modifications of ORS and barriers to universal application. RECENT FINDINGS: Solutions with osmolality and electrolyte composition different from original ORS for routine and unique pathophysiology such as in malnutrition have met with varying success. Following the conceptual rationale of sodium-glucose cotransportation to facilitate water absorption, other cotransporters and formulations have been explored with the aim to improve ORS efficacy and acceptance. ORS remains the anchor of acute watery diarrhea and dehydration management worldwide. Despite development of different formulations, the current standard solution is the mainstay of treatment for nearly all situations. Efforts to improve oral hydration solution and to increase acceptance and usage are ongoing.
PURPOSE OF REVIEW: An understanding of fluid and electrolyte losses from diarrhea and mechanisms of solute cotransport led to development of oral rehydration solution (ORS), representing a watershed in efforts to reduce diarrheal disease morbidity and mortality. This report reviews the scientific rationale and modifications of ORS and barriers to universal application. RECENT FINDINGS: Solutions with osmolality and electrolyte composition different from original ORS for routine and unique pathophysiology such as in malnutrition have met with varying success. Following the conceptual rationale of sodium-glucose cotransportation to facilitate water absorption, other cotransporters and formulations have been explored with the aim to improve ORS efficacy and acceptance. ORS remains the anchor of acute watery diarrhea and dehydration management worldwide. Despite development of different formulations, the current standard solution is the mainstay of treatment for nearly all situations. Efforts to improve oral hydration solution and to increase acceptance and usage are ongoing.
Authors: S S C Rao; R W Summers; G R S Rao; S Ramana; U Devi; B Zimmerman; B C V Pratap Journal: JPEN J Parenter Enteral Nutr Date: 2006 Sep-Oct Impact factor: 4.016
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