title: Evaluation of the efficacy of oral rehydration solutions using human whole gut perfusion.
abstract: Whole gut perfusion in humans was used to compare the effect on intestinal water and electrolyte transport of the World Health Organisation oral rehydration solution (solution II, composition in mmol/l: glucose 111, sodium 90, bicarbonate 30, potassium 20; 308 mOsm/kg); a hypertonic commercial oral rehydration solution (solution III, glucose 188, sodium 50, bicarbonate 20, potassium 20 mmol/l; 335 mOsm/kg); and three experimental bicarbonate free, hypotonic oral rehydration solutions: solution IV (glucose 111, sodium 60, potassium 20 mmol/l; 260 mOsm/kg), solution V (glucose 80, sodium 60, potassium 20 mmol/l; 219 mOsm/kg), and solution VI (glucose 80, sodium 30, potassium 20 mmol/l; 177 mOsm/kg). Perfusion of the intestine with a standard cleansing solution (solution I, sodium 125, potassium 10, bicarbonate 20, sulphate 40, mannitol 80 mmol/l; 275 mOsm/kg) confirmed published data on minimal water and sodium absorption. Experimental solution VI produced maximum water absorption (mean (SE) +1660.0 (29.8) ml/h) significantly greater than solution II (+1195.3 (79.5) ml/h), III (+534.7 (140.3) ml/h), IV (+1498.0 (42.7) ml/h), and V (+1327.7 (24.4) ml/h; p less than 0.05). Sodium absorption was significantly greater with solution II (+97.4 (7.9) mmol/h) compared to VI (+43.3 (7.8) mmol/h; p less than 0.01) but not compared to IV (+67.2 (13.0) mmol/h). A hypotonic oral rehydration solution such as solution VI may provide optimal replacement treatment for patients with acute diarrhoea.
authors.affiliation: Wellcome Research Unit, Christian Medical College and Hospital, Vellore, India.
authors.forename: D D
authors.initials: DD
authors.lastname: Rolston
authors.forename: S N
authors.initials: SN
authors.lastname: Zinzuvadia
authors.forename: V I
authors.initials: VI
authors.lastname: Mathan
mesh_terms: D000328:Adult; D001639:Bicarbonates / Q000493:pharmacokinetics; D001692:Biological Transport / Q000187:drug effects; D005069:Evaluation Studies as Topic; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000493:pharmacokinetics; D006801:Humans; D007421:Intestine, Small / Q000378:metabolism; D008297:Male; D011188:Potassium / Q000493:pharmacokinetics; D012016:Reference Values; D015532:Rehydration Solutions / Q000494:pharmacology*; D012964:Sodium / Q000493:pharmacokinetics; D014882:Water-Electrolyte Balance / Q000187:drug effects*
chemical_list: D001639:Bicarbonates; D015532:Rehydration Solutions; D012964:Sodium; D005947:Glucose; D011188:Potassium