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Graphic Reduced osmolarity oral rehydration solution for treating dehydration due to diarrhoea in children: systematic review

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7304.81 (Published 14 July 2001) Cite this as: BMJ 2001;323:81

Data supplement

  • Table A

    Table B
     
     

    Table A Summary of 13 randomised controlled trials included in the review
     

    TrialPatientsNo of patientsIntervention groupsOutcomes (considered in the review)Allocation concealment*
    Bangladesh 1995a11Children 2-15 months

    Randomised after 1 day of rehydration

    Dehydration status not known.

    		55Reduced L-alanine and glucose oral rehydration solution (255 mmol/l)

    Intravenous infusion

    Standard WHO oral rehydration solution (311 mmol/l)

    		Stool output; unscheduled IV infusionAdequate
    Bangladesh 1995b12Children 5-24 months with diarrhoea and mild to moderate dehydration

    Some with cholera

    		60Reduced osmolarity glucose oral rehydration solution (249 mmol/l)

    Standard WHO oral rehydration solution

    		Stool output; vomitingAdequate
    Bangladesh 1996a13Children 6-30 months with diarrhoea and mild to moderate dehydration 46Reduced osmolarity sucrose oral rehydration solution (198 mmol/l after full hydrolysis -> 257 mmol/l)

    Standard WHO oral rehydration solution

    		Stool output; unscheduled IV infusionAdequate
    CHOICE 200114Children 1-24 months with diarrhoea and some with severe dehydration 671Reduced osmolarity glucose oral rehydration solution (245 mmol/l)

    Standard WHO oral rehydration solution

    		Stool output; vomiting; unscheduled IV infusion; hyponatraemia Adequate
    Colombia 200015Boys 1-36 months with diarrhoea and mild or moderate dehydration 140Reduced osmolarity glucose oral rehydration solution (245 mmol/l)

    Standard WHO oral rehydration solution

    		Stool output; unscheduled IV infusion; hyponatraemiaAdequate
    Egypt 199416Children 3-24 months with diarrhoea and moderate dehydration 61Reduced osmolarity glucose oral rehydration solution (210 mmol/l)

    Standard WHO oral rehydration solution

    IV infusion

    		Stool volume; hyponatraemiaNot described
    Egypt 1996a17Children 3-24 months with non-cholera diarrhoea and moderate dehydration 90Reduced osmolarity maltodextrin oral rehydration solution (227 mmol/l)

    Standard WHO oral rehydration solution

    		Stool output; unscheduled IV infusionNot described
    Egypt 1996b18Boys 1-24 months with diarrhoea and dehydration190Reduced osmolarity glucose oral rehydration solution (245 mmol/l)

    Standard WHO oral rehydration solution

    		Stool output; unscheduled IV infusion; vomitingAdequate
    India 198419Infants 0-3 months with acute non-cholera diarrhoea and dehydration 65Reduced osmolarity glucose oral rehydration solution (270 mmol/l)

    Standard WHO oral rehydration solution (330 mmol/l)

    IV Ringer's lactate therapy

    		Stool output; unscheduled IV infusion; vomitingNot described
    India 2000a20Children 3-24 months with acute non-cholera diarrhoea and some dehydration 70Reduced osmolarity glucose oral rehydration solution (224 mmol/l)

    Standard WHO oral rehydration solution

    		Stool outputAdequate
    India 2000b21Children 3 months - 5 years with acute cholera and non-cholera diarrhoea and some with severe dehydration 170Reduced osmolarity glucose oral rehydration solution (245 mmol/l)

    Standard WHO oral rehydration solution

    		Vomiting; unscheduled IV infusionAdequate
    Mexico 1990a22Children 1-36 months with diarrhoea and dehydration186Reduced osmolarity glucose oral rehydration solution (240 mmol/l)

    Standard WHO oral rehydration solution

    		Unscheduled IV infusion; vomiting; hyponatraemiaNot described
    Panama 198223Well nourished children 3 months - 2 years with diarrhoea and dehydration 94Reduced osmolarity glucose oral rehydration solution (251 mmol/l)

    Standard WHO oral rehydration solution

    IV infusion

    		Stool output; unscheduled IV infusion; hyponatraemiaNot described
    USA 198224Well nourished children 3 months to 2 years with diarrhoea and dehydration 52Reduced osmolarity glucose oral rehydration solution (251 mmol/l)

    Standard WHO oral rehydration solution

    IV infusion

    		Stool output; unscheduled IV infusion; hyponatraemiaNot described
    WHO 199525Children aged 1-24 months admitted to hospital with diarrhoea and mild to moderate dehydration 447Reduced osmolarity glucose oral rehydration solution (224 mmol/l)

    Standard WHO ORS solution

    		Stool output; unscheduled IV infusionAdequate

    *Concealment of allocation concealment: adequate=methods given; not described=trial described as "randomised" but no methods of concealment given.
     
     

    Table B Stool output among children in 13 trials included in meta-analysis
     

    TrialOutcome
    Type of mean
    Reduced osmolarity group
     
    Standard WHO group
    No
    Mean (95% CI or SD)
    No
    Mean (95% CI or SD)
    WHO 199524Stool output at 24 h (g/kg)
    Geometric
    221
    65 (58 to 73)
     
    218
    86 (77 to 96)
    Egypt 1996a17Stool output at 24 h (g/kg)
    Geometric
    45
    226 (186 to 281)
     
    44
    200 (161 to 249)
    Egypt 1996b18Stool output for rehydration phase (g/kg)
    Geometric
    94
    11 (8 to 14)
     
    96
    15 (12 to 20)
    Bangladesh 1995a11Stool output at 0-24 h (ml/kg)
    Arithmetic
    19
    156 (113.4)
     
    19
    193 (71.2)
    Colombia 200015Stool output for rehydration period (g/kg/h)
    Arithmetic
    71
    5.6 (5.1)
     
    69
    6.3 (5.0)
    Egypt 199416Stool output at 24 h (g/kg)
    Arithmetic
    20
    165 (52)
     
    21
    260 (114)
    Bangladesh 1995b12Stool output at 0-24 h (ml/kg)
    Arithmetic
    30
    109 (73.8)
     
    30
    110 (2.7)
    Bangladesh 1996a13Stool output at 0-24 h (g/kg)
    Arithmetic
    18
    80.9 (45.3)
     
    28
    117.8 (81.0)
    India 198419Stool output at 24 h (ml/kg)
    Arithmetic
    22
    82.3 (60)
     
    22
    88.1 (58.2)
    India 2000a20Stool output during observation period (g/kg/day)
    Arithmetic
    33
    61.0 (24.5)
     
    37
    75.0 (29.4)
    Panama 198223Stool output during first 8 h (ml/kg/h)
    Arithmetic
    33
    4.3 (4.6)
     
    30
    4.3 (3.3)
    USA 198223Stool output during first 8 h (ml/kg/h)
    Arithmetic
    15
    4.2 (3.9)
     
    20
    4.6 (4.0)
    CHOICE 200114Stool output at 24 h (g/kg)
    Arithmetic
    341
    114 (73.9)
     
    334
    125 (91.4)

     

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