- Oral rehydration therapy (ORT) is a clinically useful, cost-effective, and safe technique to treat mild and moderate dehydration.
- ORT is as effective as IV hydration and the treatment of choice for mild to moderate dehydration.
- 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).
- Fruit juices, soda, popsicles, sports drinks, and broth often have inappropriate Na+ and/or electrolyte concentrations for isolated ORT.
- Although ORT can be prepared at home, commercially prepared solutions eliminate potential recipe errors.
- System(s) affected: endocrine/metabolic, gastrointestinal
- In 1980, diarrheal illness contributed to 4 to 6 million deaths annually in children age <5 years. By 2018, this declined to fewer than 500,000 annual deaths (despite a 70% increase in the world’s population).
- Acute diarrheal illness remains the second leading cause of mortality in children age <5 years in developing countries.
- Exercise-related dehydration is common (1).
Etiology and Pathophysiology
ORT takes advantage of the preserved coupled transport of Na+ and glucose in the small intestine during infectious gastroenteritis and exercise-associated dehydration. Water follows Na+ osmotically. Potassium is passively absorbed via solvent drag. An equimolar concentration of glucose and Na+ is most effective for ORT.
- Fluids with a higher ratio of glucose (juice, soda, sports drinks, etc.) have a high unabsorbed glucose load, which increases osmolality in the lumen, decreases water absorption, and increases diarrheal losses.
- Fluids with higher ratio of Na+ (chicken broth, etc.) lack enough solute for transport of Na+, leading to increased diarrheal losses (and potentially hypernatremia).
There's more to see -- the rest of this topic is available only to subscribers.
Domino, Frank J., et al., editors. "Oral Rehydration." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116416/all/Oral_Rehydration.
Oral Rehydration. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116416/all/Oral_Rehydration. Accessed May 29, 2023.
Oral Rehydration. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116416/all/Oral_Rehydration
Oral Rehydration [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 29]. 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 - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, 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 -