The World Health Organization (WHO) reported the composition of a solution for rehydrating a severely malnourished child (ReSoMal). The solution is relatively high in potassium and low in sodium.
Treatment of dehydration associated with severe malnutrition in a patient without shock:
(1) 5 mL/kg every 30 minutes for first 2 hours (4 doses)
(2) 5-10 mL/kg per hour for next 4 to 10 hours (may alternate with F75)
Risks associated:
(1) not suitable for rehydration of cholera or dehydration without malnutrition (use standard ORS)
(2) not suitable for acute malnutrition without dehydration
(3) may cause heart failure if given too rapidly.
Ingredient |
Amount |
WHO-ORS |
1 liter packet (see below) |
sugar (sucrose) |
50 g |
electrolyte and mineral solution |
40 ml (see below) |
water |
2,000 mL |
Total osmolarity of the prepared solution: 290.345 mmol/L
The final solution contains approximately:
(1) sodium 45 mmol/L
(2) potassium 40 mmol/L
(3) magnesium 3 mmol/L
(4) chloride: 76 mmol/L
(5) glucose: 125 mmol/L (from glucose and sucrose)
WHO ORS
Ingredient |
Amount |
sodium chloride |
3.5 g |
sodium citrate dihydrate |
2.9 g |
potassium chloride |
1.5 g |
glucose |
20 g |
Electrolyte and Mineral Solution
Ingredient |
Number of Grams |
Molar Content in 20 mL |
potassium chloride |
224 |
24 mmol |
tripotassium citrate |
81 |
2 mmol |
magnesium chloride |
76 |
3 mmol |
zinc acetate |
8.2 |
300 µmol |
copper sulphate |
1.4 |
45 µmol |
water addition |
final volume 2,500 mL |
|
sodium selenate (NaSeO4) |
0.028 (if available) |
|
potassium iodide |
0.012 (if available) |
|
20 mL of the solution (hence column 3) is added to 1,000 mL of milk feed
40 mL represents 1.6% of the final volume.
Specialty: Endocrinology