Oral Rehydration Therapy (ORT)
ORT is the gold standard, cost-effective treatment for managing dehydration due to diarrhea. It utilizes the sodium-glucose co-transport mechanism in the small intestine to maximize water absorption.
1. Composition of WHO ORS (Reduced Osmolarity)
The standard WHO formula is optimized to reduce stool output and the need for unscheduled IV therapy:
- Sodium: 75 mEq/L
- Glucose: 75 mmol/L
- Chloride: 65 mEq/L
- Potassium: 20 mEq/L
- Citrate: 10 mmol/L
- Total Osmolarity: 245 mOsm/L
2. Clinical Management Plans
| Plan | Indication | Key Action |
|---|---|---|
| Plan A | No dehydration | Increase home fluids; continue breastfeeding/feeding. |
| Plan B | Some dehydration | ORS 75 mL/kg over 4 hours. |
| Plan C | Severe dehydration | IV Fluids (Ringer’s Lactate/Normal Saline). |
3. High-Yield Clinical Pearls
- Sodium-Glucose Co-transport: This pathway remains intact even during severe secretory diarrhea (like Cholera), making ORT highly effective.
- Zinc Supplementation: Always provide 20 mg of elemental zinc daily for 10–14 days to reduce the duration and severity of diarrhea.
- Avoid: Do not use carbonated drinks, fruit juices, or sports drinks (too high in sugar/osmolarity, can worsen osmotic diarrhea).
NEET PG Hint: Remember: The total osmolarity of the current WHO-recommended ORS is 245 mOsm/L. This reduced osmolarity is key to its success. For more high-yield pediatric nutrition and free medical questions, visit mymedschool.org.