Oral rehydration solution (ORS) has reduced childhood deaths from diarrhoea in many countries. Recent studies suggest that the currently recommended formulation of ORS recommended by the World Health Organization (WHO) may not be optimal, and solutions that contain lower concentrations of sodium and glucose may be more effective.
To compare reduced osmolarity ORS with WHO standard ORS in children with acute diarrhoea.
CENTRAL (The Cochrane Library, Issue 3, 2004), MEDLINE (1966 to July 2004), EMBASE (1988 to July 2004), and Current Contents (July 2004) were searched. Additional trials were identified by hand searching. Content experts were contacted.
Randomized controlled trials comparing reduced osmolarity ORS with the WHO standard ORS formulation. The primary outcome was unscheduled intravenous fluid infusion. Secondary outcomes were measures of clinical illness.
Data collection and analysis
Two reviewers extracted data. We tested for heterogeneity using the Chi-square statistic, conducted sensitivity analysis by allocation concealment, and the regression approach to assess funnel plot asymmetry from selective trial publication.
The primary outcome, unscheduled intravenous fluid infusion, was reported in 11 trials. In a meta-analysis of 8 trials, reduced osmolarity ORS was associated with fewer unscheduled intravenous fluid infusions compared with WHO standard ORS (Mantel Haenzel odds ratio 0.59, 95% confidence interval 0.45 to 0.79) with no evidence for heterogeneity between trials. No unscheduled intravenous fluid infusion therapy was required in any participant in three trials.
Eleven trials reported stool output, and data suggested less stool output in the reduced osmolarity ORS group. Vomiting was less frequent in the reduced osmolarity group in the six trials reporting this. Six trials sought hyponatraemia, with events in three studies, but no obvious difference between the two arms.
In children admitted to hospital with diarrhoea, reduced osmolarity ORS when compared to WHO standard ORS is associated with fewer unscheduled intravenous fluid infusions, lower stool volume post randomization, and less vomiting. No additional risk of developing hyponatraemia when compared with WHO standard ORS was detected.
在許多國家口服電解質溶液(ORS) 減少了兒童因腹瀉的死亡率。最近研究建議，當前由世界衛生組織(WHO) 所推薦的ORS配方不是理想的，而含量是低鈉和低葡萄糖的溶液也許是更加有效的。
搜尋了CENTRAL (The Cochrane Library, Issue3, 2004), MEDLINE (1966 to July 2004), EMBASE(1988 to July 2004), and Current Contents (July 2004) 。額外的試驗是用徒手搜尋。與書刊目錄專家聯繫。
在11 次試驗中報告了初步結果,非預期的靜脈內給予水份。在8 項統合分析的試驗，較少滲透壓的ORS與世界衛生組織標準ORS作比較有較少量非預期的靜脈內注射 (Mantel Haenzel 勝算比0.59，95% 信賴區為0.45 到0.79) 沒有證據顯示在這些試驗之間有差異性。在三次試驗中任一受試者皆不需要非預期的靜脈內注射。11項試驗報告了大便排出，而且資料建議了在較少滲透壓的ORS 組別有較少大便排出。在六項試驗報告中嘔吐在較少滲透壓組別中是較少的。六項試驗中搜尋低血鈉，在三項研究中有低血鈉發生，但在二者之間沒有明顯的區別。
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。