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Oral Rehydration

Oral Rehydration is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Oral rehydration therapy (ORT) is a clinically useful, cost-effective, and safe technique to treat mild and moderate dehydration from diarrheal illness.
  • ORT is as effective as IV hydration and the treatment of choice for children with mild to moderate dehydration caused by diarrhea.
  • ORT can be divided into rehydration and maintenance phases.
  • ORT should have an osmolality of ~245 mOsm/kg, a sodium (Na+) content of ~75 mEq/L, and a glucose concentration of ~75 mmol/L (13.5 g/L) (1)[A].
  • Fruit juices, soda, popsicles, sports drinks, and broth have inappropriate Na and/or electrolyte concentrations for isolated ORT.
  • Although ORT can be prepared at home, commercially prepared solutions eliminate potential errors in homemade recipes.
  • System(s) affected: endocrine/metabolic, gastrointestinal

Epidemiology

Incidence
  • Diarrheal disease is a leading cause of childhood morbidity and mortality worldwide, causing ~2 million deaths per year (2).
  • Diarrhea and the resulting dehydration is the source of >200,000 hospitalizations annually in the United States and is responsible for >1.5 million outpatient visits (2).
  • Predominant age: Primarily infants and children, but ORT is effective for all ages.

Etiology and Pathophysiology

ORT takes advantage of the preserved coupled transport of Na+ and glucose in the small intestine during infectious gastroenteritis. Water follows Na+osmotically. Potassium is passively absorbed via solvent drag. An equimolar concentration of glucose and Na+ is most effective for ORT.

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Citation

Stephens, Mark B., et al., editors. "Oral Rehydration." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116416/all/Oral_Rehydration.
Oral Rehydration. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116416/all/Oral_Rehydration. Accessed April 24, 2019.
Oral Rehydration. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116416/all/Oral_Rehydration
Oral Rehydration [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 24]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116416/all/Oral_Rehydration.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Oral Rehydration ID - 116416 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116416/all/Oral_Rehydration PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -