Rehydration therapy

Rehydration can be administered both orally or via IV fluids

Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydration therapy can also be given by a nasogastric tube. Therapy should routinely include the use of zinc supplements. Use of oral rehydration therapy decreases the risk of death from diarrhea by about 93%.

Side effects may include vomiting, high blood sodium, or high blood potassium. If vomiting occurs, it is recommended that use be paused for 10 minutes and then gradually restarted. The recommended formulation includes sodium chloride, sodium citrate, potassium chloride, and glucose. It works as glucose increases the uptake of sodium and thus water by the intestines. A number of other formulations are also available including versions that can be made at home. However, the use of homemade solutions has not been well studied.

How Re-Hydration Works

Oral rehydration therapy was developed in the 1940s, but did not come into common use until the 1970s. Oral rehydration solution is on the World Health Organization’s List of Essential Medicines, the most effective and safe medicines needed in a health system.

Fluid from the body enters the intestinal lumen during digestion. This fluid is isosmotic with the blood and contains a high quantity, about 142 mEq/L, of sodium. A healthy individual secretes 2000–3000 milligrams of sodium per day into the intestinal lumen. Nearly all of this is reabsorbed so that sodium levels in the body remain constant.

In a diarrheal illness, sodium-rich intestinal secretions are lost before they can be reabsorbed. This can lead to life-threatening dehydration or electrolyte imbalances within hours when fluid loss is severe. The objective of therapy is the replenishment of sodium and water losses by ORT or intravenous infusion.

Administration

ORT is based on evidence that water continues to be absorbed from the gastrointestinal tract even while fluid is lost through diarrhea or vomiting. The World Health Organization specify indications, preparations and procedures for ORT.

WHO/UNICEF guidelines suggest ORT should begin at the first sign of diarrhea in order to prevent dehydration. Adults should take frequent sips from a cup.  If the person vomits, the caretaker should wait 5–10 minutes and then resume giving ORS. ORS may be given by aid workers or health care workers, health clinics and hospital settings.

We have the following IV Fluids in our MAC Clinics. IV fluids are used to  maintain fluid & electrolytes in human body.

IV Fluids to be administered

• 0.9% Normal Saline – Normal saline used to rehydrate patients in case of dehydration and patient who is unable to take water/ food by mouth.
• Dextrose Normal saline – Dextrose Normal saline is used for fluid and electrolyte replenishment and caloric supply. DNS can be used in case of weakness/ unable to eat due to severe gastritis.
• 5% Dextrose – 5% Dextrose is used to  replace lost fluids and provide carbohydrates to the body. Dextrose 5% in water is used to treat low blood sugar (hypoglycemia), insulin shock, or dehydration (fluid loss).
• Ringer Lactate – Ringer Lactate solution is used to replace fluids and electrolytes in patients with unbalanced blood fluid.