| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
American Journal of Clinical Nutrition, Vol 33, 637-663, Copyright © 1980 by The American Society for Clinical Nutrition, Inc
REVIEW ARTICLES |
N Hirschhorn
This review examines the historical, physiological, clinical, and epidemiological evidence to support a method of therapy for children's diarrhea that may be recommended for general acceptance. The understanding and use of fluid and nutritional therapy of acute diarrhea in childhood have progressed over the years to a point where acute mortality can be reduced to nearly zero. At the same time, the ill effects on electrolyte balance and nutrition may be reduced to a minimum. Through use of an oral glucose electrolyte solution with a carefully designed composition, physiologically correct treatment may now be so simplified and inexpensive as to be readily available to the remote, under-served areas of the world where most of the morbidity exists; and be useful as well to more sophisticated settings. The method of therapy recommended in this paper has several important departures from traditional teaching. It advocates rapid restoration of extracellular fluid with a polyelectrolyte solution containing sodium, base and potassium; use of an oral glucose electrolyte solution for repletion of those not in shock and for maintenance; use of a single oral glucose electrolyte solution for all age groups, regardless of diagnosis, and quite early feeding with tolerated foods. Sodium loads given are generally higher than advocated by standard pediatric teaching. The origins of that teaching and support for the newer approach come from a detailed analysis of current knowledge in the epidemiological, clinical, and physiological aspects of diarrheal illness.
This article has been cited by other articles:
|
|
 |
|
  M G Coulthard Will changing maintenance intravenous fluid from 0.18% to 0.45% saline do more harm than good? Arch. Dis. Child., April 1, 2008; 93(4): 335 - 340. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A Holliday, P. E Ray, and A. L Friedman Fluid therapy for children: facts, fashions and questions Arch. Dis. Child., June 1, 2007; 92(6): 546 - 550. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K Neville, C Verge, A Rosenberg, M O'Meara, and J Walker Is hyperchloraemic acidosis a problem in children with gastroenteritis rehydrated with normal saline? Authors' reply Arch. Dis. Child., May 1, 2007; 92(5): 466 - 466. [Full Text] [PDF]
|
|
|
|
 |
|
 G. B Haycock Hypernatraemia: diagnosis and management Arch. Dis. Child. Ed. Pract., April 1, 2006; 91(1): ep8 - ep8. [Full Text] [PDF]
|
|
|
|
|
|
K A Neville, C F Verge, A R Rosenberg, M W O'Meara, and J L Walker Isotonic is better than hypotonic saline for intravenous rehydration of children with gastroenteritis: a prospective randomised study Arch. Dis. Child., March 1, 2006; 91(3): 226 - 232. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Duggan, O. Fontaine, N. F. Pierce, R. I. Glass, D. Mahalanabis, N. H. Alam, M. K. Bhan, and M. Santosham Scientific Rationale for a Change in the Composition of Oral Rehydration Solution JAMA, June 2, 2004; 291(21): 2628 - 2631. [Full Text] [PDF]
|
|
|
|
|
|
D. R. Nalin, N. Hirschhorn, W. Greenough III, G. J. Fuchs, and R. A. Cash Clinical Concerns About Reduced-Osmolarity Oral Rehydration Solution JAMA, June 2, 2004; 291(21): 2632 - 2635. [Full Text] [PDF]
|
|
|
|
 |
|
 S Richmond Hypernatraemic dehydration: excess sodium is not the cause Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2003; 88(4): F349 - F350. [Full Text] [PDF]
|
|
|
|
 |
|
 M. G Coulthard and G. B Haycock Distinguishing between salt poisoning and hypernatraemic dehydration in children BMJ, January 18, 2003; 326(7381): 157 - 160. [Full Text] [PDF]
|
|
|
|
|
|
S Oddie, S Richmond, and M Coulthard Hypernatraemic dehydration and breast feeding: a population study Arch. Dis. Child., October 1, 2001; 85(4): 318 - 320. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. J Fuchs A better oral rehydration solution? BMJ, July 14, 2001; 323(7304): 59 - 60. [Full Text] [PDF]
|
|
|
|
 |
|
 CHOICE Study Group Multicenter, Randomized, Double-Blind Clinical Trial to Evaluate the Efficacy and Safety of a Reduced Osmolarity Oral Rehydration Salts Solution in Children With Acute Watery Diarrhea Pediatrics, April 1, 2001; 107(4): 613 - 618. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P Dutta, U Mitra, B Manna, S K Niyogi, K Roy, C Mondal, and S K Bhattacharya Double blind, randomised controlled clinical trial of hypo-osmolar oral rehydration salt solution in dehydrating acute diarrhoea in severely malnourished (marasmic) children Arch. Dis. Child., March 1, 2001; 84(3): 237 - 240. [Abstract] [Full Text]
|
|
|
|
 |
|
 U. Fagundes-Neto and J. A.B.d. Andrade Acute Diarrhea and Malnutrition: Lethality Risk in Hospitalized Infants J. Am. Coll. Nutr., August 1, 1999; 18(4): 303 - 308. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Santosham, E. M. Keenan, J. Tulloch, D. Broun, and R. Glass Oral Rehydration Therapy for Diarrhea: An Example of Reverse Transfer of Technology Pediatrics, November 1, 1997; 100(5): e10 - e10. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. K.C. Leung, P. G. Taylor, L. Geoffroy, and P. Darling Efficacy and Safety of Two Oral Solutions as Maintenance Therapy for Acute Diarrhea: A Double-blind, Randomized, Multicenter Trial Clinical Pediatrics, August 1, 1988; 27(8): 359 - 364. [Abstract] [PDF]
|
|
|
|
|
|
J. Sharifi and F. Ghavami Oral Rehydration Therapy of Severe Diarrheal Dehydration Clinical Pediatrics, February 1, 1984; 23(2): 87 - 90. [Abstract] [PDF]
|
|
|
|
|
|
G. B. Stickler A Reclamation of the Case Against Cow's Milk Clinical Pediatrics, August 1, 1982; 21(8): 492 - 493. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
