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    Different Types of Ors

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    ORS is an oral rehydration solution that can help rehydrate the body when fluid is lost due to diarrhea. It is made from a combination of salts and glucose in water. Use of ORS prevents millions of child deaths each year. ORS works by allowing absorption of water, sodium, and other electrolytes during diarrhea. WHO recommends two types of ORS - one containing bicarbonate and one containing citrate. ORS comes in various formulations including glucose-based, rice-based, low osmolarity, and home-available types. Zinc treatment along with ORS can reduce duration and severity of diarrhea.

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    Different Types of Ors

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    11K views26 pages
    ORS is an oral rehydration solution that can help rehydrate the body when fluid is lost due to diarrhea. It is made from a combination of salts and glucose in water. Use of ORS prevents millions of child deaths each year. ORS works by allowing absorption of water, sodium, and other electrolytes during diarrhea. WHO recommends two types of ORS - one containing bicarbonate and one containing citrate. ORS comes in various formulations including glucose-based, rice-based, low osmolarity, and home-available types. Zinc treatment along with ORS can reduce duration and severity of diarrhea.

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    ORS is an oral rehydration solution that can help rehydrate the body when fluid is lost due to diarrhea. It is made from a combination of salts and glucose in water. Use of ORS prevents millions of child deaths each year. ORS works by allowing absorption of water, sodium, and other electrolytes during diarrhea. WHO recommends two types of ORS - one containing bicarbonate and one containing citrate. ORS comes in various formulations including glucose-based, rice-based, low osmolarity, and home-available types. Zinc treatment along with ORS can reduce duration and severity of diarrhea.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    11K views26 pages

    Different Types of Ors

    Uploaded by

    api-3823785
    ORS is an oral rehydration solution that can help rehydrate the body when fluid is lost due to diarrhea. It is made from a combination of salts and glucose in water. Use of ORS prevents millions of child deaths each year. ORS works by allowing absorption of water, sodium, and other electrolytes during diarrhea. WHO recommends two types of ORS - one containing bicarbonate and one containing citrate. ORS comes in various formulations including glucose-based, rice-based, low osmolarity, and home-available types. Zinc treatment along with ORS can reduce duration and severity of diarrhea.

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    of 26

    ORAL REHYDRATON SOLUTION

    ORS -special combination of dry salts that, when


    properly mixed with safe water, can help
    rehydrate the body when a lot of fluid has been
    lost due to diarrhoea.
    Use of ORT prevents deaths of 1 million to 2
    million children each yr
    Basis of ORS -During Diarrhoea,even thou Na &
    H2O are lost Glucose,AA, Dipeptides are
    absorbed without difficulty.So…….
    WHO Recommended ORS types
    ORS Bicarbonate ORS Citrate
    NaCl -3.5g NaCl -3.5g
    NaHCo3 -2.5g Trisod.citrate
    KCl -1.5g dehydrate -2.9g
    Glucose -20g KCl -1.5g
    Water -1L Glucose -20g
    Water -1L
    TYPES OF DEHYDRATION
    50%cases - IsoNatremic type
    45% - Hyponatremic type
    5% - Hypernatremic type
    Why K+ in ORS?
    Why HCO3 in ORS?
    INDICATIONS
    MILD to MODERTE dehydration

    As MAINTENANCE therapy in severe


    dehydration
    TYPES OF ORS FORMULATIONS
    Glucose based ORS

    Rice based ORS

    Low osmolarity ORS

    Home available ORS

    ORS with other nutrients


    Oral Rehydration Therapy
    Home made - sugar(40g) +salt (4g) solution

    Food based -rice water(50g)+salt(40g)


    -lassi + salt

    Others -plain H2O, lemon water, coconut


    water, rice kanji, dhal water
    without salt
    WHAT IS NOT ORT?
    Glucose water without salt

    Fluids without starch / sugar & salt in children


    who are starved

    Fluids consumed in small amounts.eg- tea.


    IMPROVED ORS
    APPROACH 1:
    Glucose - replaced by starch based cereal
    powder(50g/L)
    eg:cooked rice powder
    APPROACH 2:
    Glucose polymers(Maltodextrin)OR AA are
    combined with or used instead of glucose
    ( AA & Dipeptides cause increase in
    absorption of H2O &Na by diff
    mechanism. So double benefit)
    LOW OSMOLARITY ORS

    Why low osmolarity?


    In stool output
    Dehydration
    need for IV fluids
    In both Na & Glucose results in in
    osmolarity

    Overall – 224mOsm/L(Glu-84 & Na-60)


    LOW OSMOLARITY ORS
    Reduced osmolarity ORS grams Reduced osmolarity ORS Mmol/
    /litre litre
    Sodium chloride 2.6 Sodium 75

    Glucose, anhydrous 13.5 Chloride 65

    Potassium chloride 1.5 Glucose 75

    Trisodium citrate, dihydrate 2.9 Potassium 20

    Citrate 10

    Total Weight 20.5 Total Osmolarity 245


    Standard ORS Reduced Osmolarity ORS solutions
    solution

    (mEq or mmol/l) (mEq or (mEq or (mEq or


    mmol/l) mmol/l) mmol/l)

    Glucose 111 111 75-90 75

    Sodium 90 50 60-70 75

    Chloride 80 40 60-70 65

    Potassium 20 20 20 20

    Citrate 10 30 10 10

    Osmolarity 311 251 210-260 245


    RICE BASED ORS
    Tastes better and provides more calories than the glucose-based
    culturally acceptable,
    reduces stool volume (by about 40 percent)
    shortens the duration of diarrhea in both cholera and other severe
    diarrheal diseases.

    Starches other than rice, including wheat flour and maize, have
    also been shown to reduce stool volume in patients with cholera.

    reduce diarrhea by adding more substrate to the gut lumen


    without increasing osmolality, thus providing additional glucose
    molecules for glucose-mediated absorption.
    HOME AVAILABLE ORS
    SUGAR - 3 Finger scoop &
    Salt - 3 Finger pinch &
    1L - boiled & cooled water

    Rice kanji , tea dicoction , lemon water, etc.,


    Home based ORS
    Home-prepared solutions - recommended for use
    by parents to give to their child immediately after
    an attack of diarrhoea starts and BEFORE any
    signs of dehydration occur

    Basically, the idea is to PREVENT dehydration


    and PRESERVE good nutritional status by
    maintaining fluid and food intake.
    HOME MADE ORS
    Home made ORS recipe
    Preparing a 1 (one) litre oral rehydration solution [ORS] using Salt,
    Sugar and Water at Home
    Mix an oral rehydration solution using one of the following recipes;
    depending on ingredients and container availability:

    Ingredients:
    one level teaspoon of salt
    eight level teaspoons of sugar
    one litre of clean drinking or boiled water and then cooled
    5 cupfuls (each cup about 200 ml.)
    ORS WITH NUTRIENTS
    Why nutrients?

    Nutrients help in absorption of Na & H2O

    Hastens recovery of intestinal epithelium


    ADVANTAGES OF ORS
    More physiological
    Easy to administer
    Cost effective
    Home equivalents available
    Free of cost at PHC ,Subcenters
    Readily available & needs no sterilisation
    DISADVANTAGES OF ORS
    INEFFECTIVE when,
    Stool purge is high (>5ml/kg/hr)
    Persistent vomitting
    Incorrect preparation /administration
    Abd. Distension & Ileus
    Glusose malabsorption cases

    Most importantly , ORS doesn’t reduce severity /


    duration of diarrhoea
    OTHERS
    Another possible way to produce a better oral
    rehydration solution would be to combine the
    standard solution with nutrients and vitamins
    that have been shown to modify the courses of
    diarrheal illnesses, probably by their
    antioxidative actions. These include vitamin
    A, zinc, magnesium, selenium, and
    other micronutrients
    ZINC TREATMENT
    zinc deficiency caused by limitations in the diet is a
    common problem and a contributing factor to the
    high prevalence of some infectious diseases in
    children, including pneumonia and diarrhea.
    Recent studies suggest that a 10- to 14-day therapy
    of zinc treatment can considerably reduce the
    duration and severity of diarrheal episodes, decrease
    stool output, and lessen the need for hospitalization.
    Zinc may also prevent future diarrhea episodes for
    up to three months.
    ADVICE
    REST THE GUT Theory
    Give as much as ORS –NO Harm in feeding excess
    DO NOT stop breast feeding during ORT
    Non breast fed infants(<6m)- additional 100-200ml of
    clean water during first 4 hrs
    <2yrs -1 teaspoon q1-2M
    Older children – freq. sips in a cup
    If child vomits – wait for 10 mins & start again slowly
    Avoid high fibre diet during ORT
    Staple foods – to be enriched with fats& oils/sugars
    eg:rice +milk/curd &sugar
    REFERENCES
    The New England Journal Of Medicine
    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&d
    b
    http://www.pjonline.com/Editorial/20040508/articles/p580oralreh
    ydration.html
    http://www.rehydrate.org/ors/rice_based_ors.htm
    http://www.rehydrate.org/ors/solution_for_survival.htm
    http://www.unu.edu/unupress/food/8F172e/8F172E04.htm
    http://www.supply.unicef.dk/Catalogue/bulletin9.htm
    http://www.eddcontrol.org/index.htm#ORS
    PARK Textbook of medicine
    Text book on PAEDIATRICS by O.P.Ghai
    Control of diarrhoeal diseases by WHO
    ORS

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