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.
