Oral rehydration salts with high potassium and low sodium contents
Indications
Prevention and treatment of dehydration, in children suffering from complicated acute malnutrition only
Forms and strengths
Sachet containing 84 g of powder,to be diluted in 2 litres of clean,boiled and cooled water
Composition for one litre:
ingredients
mmol/litre
Glucose
55
Saccharose
73
Sodium
45
Potassium
40
Chloride
70
Ingredients
mmol/litre
Citrate
7
Magnesium
3
Zinc
0.3
Copper
0.045
Osmolarity
294 mEq/litre
Dosage and duration
Prevention of dehydration
Child: 5 ml/kg after each loose stool as long as diarrhoea persists
Child under 5 kg: 25 ml
Child 5 to 9 kg: 50 ml
Child 10 to 19 kg: 100 ml
Child 20 kg and over: 200 ml
Treatment of some dehydration
Child: 20 ml/kg/hour for 2 hours orally or by nasogastric tube. If improvement (diarrhoea and signs of dehydration regress), reduce to 10 ml/kg/hour until there are no signs of dehydration and/or target weight is reached, then change to prevention of dehydration as above.
Treatment of severe dehydration
Only if there is no circulatory impairment and rehydration by oral route or nasogastric tube is tolerated:Child: 20 ml/kg/hour for 1 hour orally or by nasogastric tube. If improvement (diarrhoea and signs of dehydration regress), continue with 20 ml/kg/hour for 2 hours, then reduce to 10 ml/kg/hour, as for some dehydration.
Contra-indications, adverse effects, precautions
Do not administer to patients with cholera or uncomplicated acute malnutrition: use standard ORS instead.
Closely monitor rate of administration.
Maycause:
fluid overload (increased respiratory and heart rates and new onset or worsening of oedema). In this event, stop ReSoMal for one hour then reassess the child’s condition;
heart failure when administered too rapidly.
Remarks
ReSoMal can also be administered in adults suffering from complicated acute malnutrition, including in pregnant or breastfeeding women.
Storage
– Below 25 °C
Do not use the powder if it has turned sticky.
Once prepared, the solution should be used within 24 hours.