ORAL REHYDRATION SOLUTIONS FORMULAS
Gastrointestinal diseases with diarrheal complications are one of the main causes of morbidity and mortality in the world. Oral rehydration therapy and the formulation of oral rehydration salts were proposed in the late 1970s by WHO-UNICEF to combat the consequences of diarrheal diseases, and they agreed to promote a single solution with an osmolarity of 330 Mmol/l.
During the 90’s great advances have been made using this type of solution, helping to avoid more than 1 million annual deaths in children under 5 years of age. Subsequently, the ESPGHAM (European Society of Gastroenterology, Hepatology and Pediatric Nutrition) recommended a new improved formula with an osmolarity of between 200 and 250 mmol / l, since the oral rehydration salts with reduced osmolarity produce an optimal absorption of water ensuring an adequate replacement of sodium, potassium and bicarbonate. In addition, they also contain chlorine, bases and the potassium necessary, since significant amounts of these elements are lost in diarrheal stools.
The last study of this type of formulation was done in five developing countries, among children from one month to two years of age with diarrhea and dehydration. The results of this study suggest that the use of a solution with low sodium and glucose content reduces the need for intravenous fluids by 33%. The effects of this reduction could result in fewer children requiring hospitalization, fewer secondary infections, a decrease in the need to manage the potentially dangerous consequences of these situations, and fewer health care costs.
WHO, UNICEF, ESPGHAN RECOMMENDATIONS:
Throughout the time and thanks to the scientific advances, the formulations of the ORS have been changing until the year 2002 when the last type of SRO denominated oral rehydration salts of low osmolality was proposed by the European Society of Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) which is a multi-professional organization whose goal is to promote children’s health through the creation of knowledge, dissemination of information based on science and promotion of best practices in the provision of services. This organization has focused its efforts on improving ORS compositions to allow better treatment for all children.
Today, ORS are the first-line products that meet the nutritional needs of infants, children and adults in cases of dehydration.