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Excerpt
As investigators attempt to find a “super” oral rehydrating solution (ORS) that will be better absorbed, assessment of the effectiveness of ORS relies on clinical signs of hydration and pre- and post-therapy weights. There are no in vivo studies in children to determine the quantity of the traditional ORS that is malabsorbed. To determine the fate of ORS we performed a pilot study in 3 boys with acute diarrhea, ages 3, 12, and 15 months, by administering together with the first dose of ORS (Na=45 mmol/l), 1 ml/kg of the stable, non radioactive isotope H218O orally (PO) and simultaneously, 0.1 mg/kg 2H2O intravenously(IV). All urine and stool passed during the subsequent 24 hr were collected and analyzed separately for stable isotope enrichment by mass spectrometry. The decay curves of both, the urinary and fecal isotope enrichment for the PO- and IV-administered isotopes were almost parallel to each other, suggesting that the fate of ORS is similar to that of intravascular water. Thefigure below is representative of the PO/IV ratios of fecal isotopic enrichment found in our patients. This would indicate that in the patients we studied, ORS was very efficiently absorbed and fecal losses were the result of ongoing water losses and not from significant ORS malabsorption. This methodology can be applied to the in vivo study of the effectiveness of different ORS.
