Oral Rehydration Therapy
Oral Rehydration Therapy
Oral Rehydration Therapy
therapy
Jervin mano
What is oral
rehydration therapy?
Rehydrating a
dehydrated
person through
oral route is
called as ORT .
AIM
To correct the
water
&electrolyte
deficiet
To prevent
dehydration
Reduce mortality
PROOF?
A study in
kolkatta
showed
90-95% of all
cases of
cholera
´
diarrhoea can
be treated
Mortality rate in cholera has been reduc
with ors alone
to 0.11%
.
from 49.3%
PRINCIPLE
Glucose when
given orally
enhances the
intestinal
absorption of
salt & water.
Thus it can
correct
electrolyte &
water deficit.
WHOM CAN IT BE
GIVEN?
IN WHAT
CONDITIONS CAN
IT BE GIVEN?
All age groups
All aetiologies
All countries
TYPES OF ORS??
Sodium bicarbonate based
Trisodium citrate based
Reduced osmolarity ORS
Super ORS
Sodium bicarbonate
based ORS
Composition
Contents (gm)
NaCl 3.5
Glucose 20.0
KCl 2.5
Sodium 2.5
bicarbonate
Disadvantages
Less stable
Stool output not
reduced
Trisodium
citrate based
ORS
Composition
Contents (gm)
NaCl 3.5
Glucose 20.0
KCl 1.5
Trisodiu 2.0
m citrate
Osmolarity
Na + 90mM
Cl +
80mM
Glucose 110mM
K+ 20mM
Citrate 10mM
TOTAL 310mM
Advantages
More stable
Less stool
output in high
output
diarrhoea
Tri Na
citrate-
increases
intestinal
absorption of
Na & water
Possible adverse
effects
Hyper
tonicity in
net fluid
absorption
To overcome this
We should reduce the
osmolarity of the ORS
Reduced
osmolarity
ORS
Composition
Contents (gm)
NaCl 2.6
Glucose 13.5
KCl 1.5
Trisodium 2.9
citrate
Osmolarity
Na + 75mM
Cl +
65mM
Glucose 75mM
K+ 20mM
Citrate 10mM
TOTAL 245mM
Advantages
Increased efficacy of ORS in non
cholera diarrhoea
Need for unscheduled supplement
IV therapy in children fell by
33%.
Stool output decreased by 20%.
Vomiting decreased by 30%.
Safe & effective .
DOSAGE &
REQUIREMENT?
If the child’s weight is known,
the amount of ORS soln.for
rehydration during the first 4hrs
may be calculated as 75ml/kg
DOSAGE & REQUIREMENT?
Nursing +
treatment
with ORS
solution
Non breast fed infants less
than 6 months
Along with ORS solution give
100-200 ml of clean water for
first 4 hours
Where is it
available ?
PHC
Sub centers
Hospitals
Chemist shops
Cost?
Free
How to prepare
it ?
Dissolve the entire contents of
the packet in 1l of drinking
water
It should be used within 24
hours
If ORS packets are
not available ?
Table salt (5gm) + sugar (20gm)
in 1l of drinking water
Administer till
the diarrhea
stops
Earlier the
treatment is
instituted the
better is for
the patient
ORT programme
First started in 1986-1987
Implemented through RCH
programme
ORS packets are supplied by the
central govt.
Twice a year 150 packets of ORS
are provided as apart of drug kit
supplied to all sub centers in the
country
Theme
Adequate nutritional care of
child with diarrhoea
Proper advice to mother in
feeding
Achievements &
benefits
Low cost treatment
Treatment of the patient in their
own homes
Ingredients are inexpensive and
readily available
Achievements &
benefits
Drinking water is sufficient (no
need for boiling or other means
of sterilization)
Breakthrough in the fight
against cholera and other
diarrheal diseases
Mortality rate in cholera has
been reduced to 0.11% from
49.3%