A brief overview of composition of ORS and the rationale behind it.

1. O.R.S.
The rationale behind the
composition

2. Historical Perspective
Discovery of ORS
A Combination of Scientific Vigour & Serendipity

3. 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

4. 1962, Captain Phillips
Combined Glucose & Sodium
Ignorant of Co- transport physiology
Dr David Nalin interview, 1992

7. Glucose
Na+
H2O
K+
ORS

8. Why Potassium?
Long standing diarrhea leads to
Hypokalemia.
Malaise
Muscle Weakness
Paralytic ileus

9. Why Citrate?
Tri Sodium citrate is a basic salt which corrects
Acidosis.

10. MAGIC BULLET: The History Of Oral Rehydration Therapy
Joshua Ruxin, Medical History, 1994.

11. 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

13. .ReSoMal
(Rehydration Solution for
Malnourished)
UNICEF Technical Bulletin, Mar 2012

14. Rice based ORS
Glucose replaced by starch
& oligosaccharides
Zinc ORS
Zinc reduces the duration
of diarrhea in pediatric
patients.
M.K.Bhan et al., N Engl J Med., 1995

15. Home – made ORS
www.rehydrate.org

16. Substitutes for ORS
Breast milk
Rice porridge – Conjee
Carrot juice
If possible, Orange juice, Banana & coconut water
may be added for Potassium

17. Severe Dehydration
i.v., fluids
Normal Saline
0.9%NaCl
Ringer’s lactate
Sodium Lactate
Sodium Chloride
Potassium Chloride
Calcium Chloride

18. Further Reading:
Essential Paediatrics, O.P.Ghai.
www.rehydrate.org
Magic Bullet: The History Of Oral Rehydration
Therapy, Joshua Ruxin, Medical History, 1994.

19. Thank you!