REDUCED OSMOLARITY ORAL REHYDRATION SALT IN CHOLERA

In a controlled clinical trial conducted in 34 adults with severe chol era diarrhoea, the use of a relatively dilute oral rehydration salt (O RS) solution (sodium 67, potassium 20, chloride 66, citrate 7, glucose 89 mmol/l, osmolality 249 mOsmol/kg) caused a 29% (p = 0.003) reducti on in stool output over the first 24 h and a 37% (p = 0.001) reduction over the first 48 h compared with 29 controls who received the hypero smolar WHO/UNICEF ORS. No controls but 3 study-group patients had mark ed but asymptomatic hyponatraemia (sodium < 125 mmol/l) at 24 h. Twent y-four % of controls and 12% of patients receiving the dilute ORS need ed unscheduled intravenous therapy for recurrence of dehydration. The ORS intake was twice the 48 h stool volume in controls and 3 times in the study group. The test ORS with a reduced glucose and sodium concen tration is more efficient than the WHO/UNICEF ORS in preserving net in testinal fluid balance in severe cholera.