Double blind, randomised controlled clinical trial of hypo-osmolar oral rehydration salt solution in dehydrating acute diarrhoea in severely malnourished (marasmic) children

AIMS—To compare the clinicalefficacy of hypo-osmolar oral rehydration salt (ORS) solution (224 mmol/l) and standard ORS solution (311 mmol/l) in severely malnourished(marasmic) children having less than 60% Harvard standard weight forage with dehydrating acute watery diarrhoea.
METHODS—In a double blind,randomised, controlled trial, 64 children aged 6-48 months wererandomly assigned standard (n = 32) or hypo-osmolar ORS (n = 32).
RESULTS—Stool output (52.3 v 96.6 g/kg/day), duration of diarrhoea(41.5 v 66.4 hours), intake of ORS (111.5 v 168.9 ml/kg/day), and fluid intake (214.6 v 278.3 ml/kg/day) were significantly less in the hypo-osmolar group than in the standard ORS group. Percentage ofweight gain on recovery in the hypo-osmolar group was also significantly less (4.3 v 5.4% of admissionweight) than in the standard ORS group. A total of 29 (91%) childrenin the standard ORS group and 32 (100%) children in the hypo-osmolargroup recovered within five days of initiation of therapy. Mean serumsodium and potassium concentrations on recovery were within the normalrange in both groups.
CONCLUSION—Our findings suggestthat hypo-osmolar ORS has beneficial effects on the clinical course ofdehydrating acute watery diarrhoea in severely malnourished (marasmic)children. Furthermore, children did not become hyponatraemic afterreceiving hypo-osmolar ORS.