Abstract
Ninety four children aged less than 5 years with diarrhoeal dehydration and acidosis were treated randomly with either World Health Organisation (WHO) oral rehydration solution containing sodium chloride, potassium chloride, sodium bicarbonate and glucose or an oral solution with tripotassium citrate monohydrate replacing the sodium bicarbonate and potassium chloride in the WHO solution. Fifty five children (58%) were hypokalaemic (potassium less than 3.5 mmol/l) on admission. All but two in the citrate group were successfully treated. There were no significant differences in rehydration solution intake, stool output, gain in body weight, and fall in plasma specific gravity and haematocrit between the two treatment groups after 48 hours' treatment. Significant improvement in the serum potassium concentration was observed in the hypokalaemic children receiving potassium citrate solution compared with children receiving WHO solution after 24 and 48 hours' treatment. None developed hyperkalaemia. Although children receiving potassium citrate solution corrected their acidosis at a slower rate than the WHO solution group during the first 24 hours, by 48 hours satisfactory correction was observed in all. Tripotassium citrate can safely replace sodium bicarbonate and potassium chloride and may be the most useful and beneficial treatment for diarrhoea and associated hypokalaemia.
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Selected References
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- Dean A. G., Ching Y. C., Williams R. G., Harden L. B. Test for Escherichia coli enterotoxin using infant mice: application in a study of diarrhea in children in Honolulu. J Infect Dis. 1972 Apr;125(4):407–411. doi: 10.1093/infdis/125.4.407. [DOI] [PubMed] [Google Scholar]
- Garrow J. S., Pike M. C. The long-term prognosis of severe infantile malnutrition. Lancet. 1967 Jan 7;1(7480):1–4. doi: 10.1016/s0140-6736(67)92417-8. [DOI] [PubMed] [Google Scholar]
- Guerrant R. L., Brunton L. L., Schnaitman T. C., Rebhun L. I., Gilman A. G. Cyclic adenosine monophosphate and alteration of Chinese hamster ovary cell morphology: a rapid, sensitive in vitro assay for the enterotoxins of Vibrio cholerae and Escherichia coli. Infect Immun. 1974 Aug;10(2):320–327. doi: 10.1128/iai.10.2.320-327.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hirschhorn N. Letter: Single solution for oral therapy of diarrhoea. Lancet. 1975 Nov 22;2(7943):1049–1049. doi: 10.1016/s0140-6736(75)90351-7. [DOI] [PubMed] [Google Scholar]
- Islam M. R., Samadi A. R., Ahmed S. M., Bardhan P. K., Ali A. Oral rehydration therapy: efficacy of sodium citrate equals to sodium bicarbonate for correction of acidosis in diarrhoea. Gut. 1984 Aug;25(8):900–904. doi: 10.1136/gut.25.8.900. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Molla A. M., Rahman M., Sarker S. A., Sack D. A., Molla A. Stool electrolyte content and purging rates in diarrhea caused by rotavirus, enterotoxigenic E. coli, and V. cholerae in children. J Pediatr. 1981 May;98(5):835–838. doi: 10.1016/s0022-3476(81)80863-3. [DOI] [PubMed] [Google Scholar]
- Nalin D. R., Harland E., Ramlal A., Swaby D., McDonald J., Gangarosa R., Levine M., Akierman A., Antoine M., Mackenzie K. Comparison of low and high sodium and potassium content in oral rehydration solutions. J Pediatr. 1980 Nov;97(5):848–853. doi: 10.1016/s0022-3476(80)80287-3. [DOI] [PubMed] [Google Scholar]
- Yolken R. H., Kim H. W., Clem T., Wyatt R. G., Kalica A. R., Chanock R. M., Kapikian A. Z. Enzyme-linked immunosorbent assay (ELISA) for detection of human reovirus-like agent of infantile gastroenteritis. Lancet. 1977 Aug 6;2(8032):263–267. doi: 10.1016/s0140-6736(77)90951-5. [DOI] [PubMed] [Google Scholar]