Oral rehydration solution in the year 2000: pathophysiology, efficacy and effectiveness

被引:33
作者
Desjeux, JF
Briend, A
Butzner, JD
机构
[1] Conservatoire Natl Arts & Metiers, INSERM U290, F-75003 Paris, France
[2] Conservatoire Natl Arts & Metiers, Chair Biol, F-75003 Paris, France
[3] Hop St Lazare, ORSTOM, INSERM U290, F-75475 Paris, France
[4] Univ Calgary, Dept Pediat, Calgary, AB T2N 4N1, Canada
来源
BAILLIERES CLINICAL GASTROENTEROLOGY | 1997年 / 11卷 / 03期
关键词
dehydration; diarrhoea; rehydration solutions; fluid therapy; glucose; electrolyte; starch; nutrition disorders; mortality; knowledge; attitudes;
D O I
10.1016/S0950-3528(97)90029-4
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The use of oral rehydration solution (ORS) with early refeeding forms the basis of therapy for dehydration secondary to diarrhoea. ORS has produced such positive results in dehydrated patients that no further scientific demonstration is needed to confirm its efficacy. This review presents several issues that remain unsettled or controversial. They include the following. 1. The mechanism of water handling by the intestine is discussed; this is more complex than initially thought, at the epithelial, cellular and molecular level. 2. The composition of ORS which has been successfully adapted for the most frequent conditions, except for severely malnourished children, is described. 3. in contrast to the strong scientific basis and obvious efficacy in rehydration of ORS, its consequences for growth, nutrition and mortality are difficult to demonstrate, unless adequate long-term nutritional support is also provided in addition to ORS. 4. Finally, discrepancies between the recommendations and the practice of oral rehydration therapy are now well documented. Analysis of the causes of these discrepancies may participate in improving public health campaigns.
引用
收藏
页码:509 / 527
页数:19
相关论文
共 89 条
[11]  
BRIEND A, 1989, LANCET, V2, P319
[12]  
BRIEND A, 1993, EUR J CLIN NUTR, V47, P750
[13]  
BROWN KH, 1994, PEDIATRICS, V93, P17
[14]   DETERMINANTS OF DIETARY-INTAKE DURING CHILDHOOD DIARRHEA AND IMPLICATIONS FOR APPROPRIATE NUTRITIONAL THERAPY [J].
BROWN, KH ;
PEREZ, F .
ACTA PAEDIATRICA, 1992, 81 :127-132
[15]   EFFECTS OF MALNUTRITION ON MICROVILLUS MEMBRANE GLUCOSE-TRANSPORT AND PHYSICAL-PROPERTIES [J].
BUTZNER, JD ;
BROCKWAY, PD ;
MEDDINGS, JB .
AMERICAN JOURNAL OF PHYSIOLOGY, 1990, 259 (06) :G940-G946
[16]   IMPACT OF CHRONIC PROTEIN-CALORIE MALNUTRITION ON SMALL INTESTINAL REPAIR AFTER ACUTE VIRAL-ENTERITIS - A STUDY IN GNOTOBIOTIC PIGLETS [J].
BUTZNER, JD ;
BUTLER, DG ;
MINIATS, OP ;
HAMILTON, JR .
PEDIATRIC RESEARCH, 1985, 19 (05) :476-481
[17]  
BUTZNER JD, 1990, PEDIATR RES, V27, P245, DOI 10.1203/00006450-199003000-00008
[18]   REFEEDING ENHANCES INTESTINAL REPAIR DURING AN ACUTE ENTERITIS IN INFANT RABBITS SUBJECTED TO PROTEIN-ENERGY MALNUTRITION [J].
BUTZNER, JD ;
GALL, DG .
PEDIATRIC RESEARCH, 1991, 29 (06) :594-600
[19]   STUDIES IN PROTEIN-CALORIE MALNUTRITION .I. CHEMICAL EVIDENCE FOR MAGNESIUM DEFICIENCY [J].
CADDELL, JL ;
GODDARD, DR .
NEW ENGLAND JOURNAL OF MEDICINE, 1967, 276 (10) :533-&
[20]   FASTING ALTERS BASAL AND STIMULATED ION-TRANSPORT IN PIGLET JEJUNUM [J].
CAREY, HV ;
HAYDEN, UL ;
TUCKER, KE .
AMERICAN JOURNAL OF PHYSIOLOGY, 1994, 267 (01) :R156-R163