Efficacy and safety of a modified oral rehydration solution (ReSoMaL) in the treatment of severely malnourished children with watery diarrhea☆
Section snippets
Patients and methods
This double-blind, controlled study was conducted at the Clinical Research and Service Centre of ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh. The Ethical Review Committee of ICDDR,B approved the protocol, and voluntary, informed consent was obtained from parents of the children before study enrolment. Eligible children were age 6 to 36 months of either gender with a history of watery diarrhea for ≤10 days and severe malnutrition (weight for length <70% of the National
Results
A total of 296 children were screened for eligibility, of whom 130 were enrolled (65 in the WHO-ORS group and 65 in the ReSoMaL group) between the period of February 1998 to January 2000. Twelve children were withdrawn from the study: seven from the ReSoMaL group (three for development of severe dehydration requiring intravenous fluids, and one each for symptomatic hypokalemia, severe hyperkalemia at 0 hours, severe pneumonia, and symptomatic hyponatremia—Na 108 mmol/L with seizure) and five
Discussion
Results of this randomized, controlled efficacy and safety trial of ReSoMaL demonstrate that this modified ORS corrects dehydration in severely malnourished children with diarrhea. Although currently recommended, there is little experience with ReSoMaL in the treatment of diarrhea in severely malnourished children, and its efficacy in relation to patient characteristics has not been previously reported.13., 5. In an experimental absorption study using perfusion techniques in human adult
Acknowledgements
Dr Alam was involved in proposal and protocol development, all phases and management of the study, data analysis, and manuscript preparation. Dr Hamadani was involved in clinical treatment of the study patients and assisted in manuscript preparation. Dr Dewan was involved in proposal and protocol development and clinical care of the study patients. Prof Fuchs was involved in proposal and protocol development, data analysis, and manuscript preparation. ICDDR,B acknowledges with gratitude the
References (31)
- et al.
Mortality in severely malnourished children with diarrhoea and use of a standardised protocol
Lancet
(1999) - et al.
Efficacy and safety of oral rehydration solution with reduced osmolarity in adults with cholera: a randomised double-blind clinical trial
Lancet
(1999) - et al.
Reduced osmolarity oral rehydration solution for persistent diarrhea in infants: a randomized controlled clinical trial
J Pediatr
(2001) - et al.
Epidemiology and causes of death among children in a rural area of Bangladesh
Int J Epidemiol
(1980) - et al.
Mortality associated with acute watery diarrhoea, dysentery, and persistent diarrhoea in rural North India
Acta Paediatr Suppl
(1992) - et al.
Why have mortality rates for severe malnutrition remained so high?
Bull WHO
(1996) - et al.
Treatment of severe child malnutrition in refugee camps
Eur J Clin Nutr
(1993) Malnutrition: marasmus and kwashiorkor
Severe malnutrition
- et al.
Potassium in protein calorie malnutrition
South Afr Med J
(1972)
Studies on total body potassium in infantile malnutrition: the relation to body fluid spaces and urinary creatinine
Clin Sci
Hypokalaemia in children with diarrhoea in rural Bangladesh
Ind J Med Res
Acute diarrhoea in malnourished children: clinical, biochemical and bacteriological profile
Indian Pediatr
Neuromuscular manifestations of diarrhoea related hypokalaemia
Indian Pediatr
Efficacy of oral rehydration solution in correcting serum potassium deficit of children with acute diarrhoea in Bangladesh
J Trop Pediatr
Cited by (38)
Cholera
2017, The LancetCitation Excerpt :ReSoMal, the special oral rehydration solution for children with severe acute malnutrition, has been found to be associated with symptomatic hyponatraemia in children who also have cholera. Instead, the standard oral rehydration solution recommended by WHO should be used.112 Vomiting is common in patients who are dehydrated and acidotic, but usually subsides with appropriate rehydration.
Cholera Presenting with Hyperkalemia, Rhabdomyolysis, and Acute Renal Failure
2021, Military Medicine
- ☆
Supported by a grant from the World Health Organization (grant no. C6/181/377).