Efficacy of oral rehydration solution in correcting serum potassium deficit of children with acute diarrhoea in Bangladesh.

Abstract

60 children in Bangladesh all under 4 years of age with acute watery diarrhea and moderate dehydration were treated with sucrose based oral rehydration solution (ORS) with 20mEq potassium chloride per liter and monitored to determine the efficacy of this fluid in raising serum potassium level. ORS only was given for the 1st 4 hours and then the child was given diluted mild formula and bread as well. No fruits or potassium rich fluid (e.g. green coconut water) were allowed during the study period. Rehydration as well as maintenance of fluid loss was done with ORS only. The serum potassium dropped significantly at 24 hours from the admission level and remained reduced at that level even after 48 hours of therapy with ORS. Of these 60 patients 22 were hypokalaemic on admission and 10 patients out of 19 remained so after 48 hours of therapy. Thus it appears that the present concentration of potassium in World Health Organization recommended ORS is not sufficient to correct deficits in some patients. The significance of these findings can be appreciated by considering the fate of infants in areas where diarrhea is hyperendemic who may have 3 attacks per year per child on average and who are in addition malnourished. Total potassium depletion may occur in these children during repeated diarrheal episodes resulting in higher morbidity and mortality. These findings suggest the need to raise the potassium concentration in ORS to above 20mEq per liter.