Efficacy of Oral Rehydration Solution in Correcting Serum Potassium Deficit of Children with Acute Diarrhoea in Bangladesh

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Abstract
Sixty children under 4 years of age with acute watery diarrhoea and moderate dehydration were treated with sucrose based oral rehydration solution (ORS) with 20mEq potassium chloride per litre and monitored to determine the efficacy of this fluid in raising serum potassium level. ORS only was given for the first 4 hours and then the child was given diluted milk formula and bread as well. No fruits or potassium rich fluid (e.g. green coconut water) were allowed during the study period. Rehydration as well as maintenance of fluid loss was done with ORS only. The serum potassium dropped significantly (p < 0.01) at 24 hours from the admission level and remained reduced at that level even after 48 hours of therapy with ORS. Of these 60 patients, 22 were hypokalaemic (serum potassium < 3.5 mEq/l) on admission and 10 patients out of 19 remained so after 48 hours of therapy. Thus, it appears that the present concentration of potassium in World Health Organization recommended ORS is not sufficient to correct deficits in some patients. The implications of this in underdeveloped countries where repeated attacks of diarrhoea are very common in children, is discussed.