O.R.S. The rationale behind
the composition
Oct. 2006
Historical PerspectiveDiscovery of ORS
A Combination of Scientific Vigour & Serendipity
David R. Nalin
Two Approaches
Analyzing the composition of stool.
Analyzing the alteration in the composition of Extracellular Fluid in the body.
Daniel Darrow, et al., J. Pediatr., 1949
1962, Captain PhillipsCombined Glucose & Sodium
Ignorant of Co- transport physiology
Dr David Nalin interview, 1992
The discovery that sodium transport
and glucose transport
are coupled in the small intestine
so that glucose accelerates
absorption of solute and water
(is) potentially the most important
medical advance this century
August, 1978
Glucose
Na+
H2O
K+
ORS
Why Potassium?
Long standing diarrhea leads to Hypokalemia.
Malaise
Muscle Weakness
Paralytic ileus
Why Citrate?
Tri Sodium citrate is a basic salt which corrects Acidosis.
MAGIC BULLET: The History Of Oral Rehydration TherapyJoshua Ruxin, Medical History, 1994.
Content Standard ORS Low Osmolar ORS
Glucose 111 75
Sodium 90 75
Chloride 80 65
Potassium 20 20
Citrate 10 10
Osmolarity 311 245
WHO ORS
.ReSoMal(Rehydration Solution for
Malnourished)
UNICEF Technical Bulletin, Mar 2012
Rice based ORSGlucose replaced by starch
& oligosaccharides
Zinc ORSZinc reduces the duration
of diarrhea in pediatric patients.
M.K.Bhan et al., N Engl J Med., 1995
Home – made ORS
www.rehydrate.org
Substitutes for ORS
Breast milk
Rice porridge – Conjee
Carrot juice
If possible, Orange juice, Banana & coconut water may be added for Potassium
Severe Dehydrationi.v., fluids
Normal Saline
0.9%NaCl
Ringer’s lactate
Sodium Lactate
Sodium Chloride
Potassium Chloride
Calcium Chloride
Further Reading:
Essential Paediatrics, O.P.Ghai.
www.rehydrate.org
Magic Bullet: The History Of Oral Rehydration Therapy, Joshua Ruxin, Medical History, 1994.
Thank you!
