Abstract

PIP: Questions about the suitability of a single oral electrolyte solution containing 90 mmol/liter of sodium for rehydration therapy in diarrhea are raised because of the possibility of repeating the experience of 30 years ago in the U.S. when widespread use of electrolyte solutions and commercial milk preparations resulted in the so-called era of hypertonicity. Given that most diarrhea cases requiring rehydration occur in developing countries where nutrition is questionable and given that even in developing countries hypernatremia occurs too frequently, the letter writers argue that the single formulation of an oral therapy solution may be ill-advised. Studies on oral fluid therapy have been carried out in children over 2 years of age in developing countries, and it was found that children with underlying hypertonicity secondary to high solute artificial feedings were pushed to the fringe of their extracellular-volume and renal-function tolerances. The letter writers argue for further studies of the suitability of such a high sodium concentration in the electrolyte solution and feel that a mixture with a lower sodium concentration in the under 2 age group in developing countries is more suitable.