What are the recommended fluids for treating dehydration?

From the Guidelines

For dehydration, oral rehydration solutions (ORS) like Pedialyte are the most effective choice, as they provide both water and electrolytes that help the body absorb and retain fluid more effectively than water alone 1. When it comes to dehydration, the goal is to replenish lost fluids, electrolytes, and nutrients.

• Oral rehydration solutions are recommended as the first-line therapy for mild to moderate dehydration in infants, children, and adults with acute diarrhea from any cause 1.
• The most effective ORS solutions contain a balanced mix of sodium, potassium, and glucose, which help to enhance water absorption in the intestine 1. Some key points to consider when using ORS:
• For mild dehydration, consume about 1-2 liters over 2-4 hours; for moderate cases, adults may need 3-4 liters 1.
• Aim to drink small amounts frequently rather than large volumes at once.
• Avoid alcohol, caffeinated beverages, and undiluted fruit juices as they can worsen dehydration.
• If symptoms like extreme thirst, dizziness, confusion, or minimal urination persist after 24 hours of home treatment, seek medical attention immediately. It's also important to note that:
• Isotonic intravenous fluids such as lactated Ringer’s and normal saline solution should be administered when there is severe dehydration, shock, or altered mental status and failure of ORS therapy 1.
• Nasogastric administration of ORS may be considered in infants, children, and adults with moderate dehydration, who cannot tolerate oral intake, or in children with normal mental status who are too weak or refuse to drink adequately 1.

From the Research

Dehydration Treatment Options

To address dehydration, various fluids can be consumed, but their effectiveness and suitability vary depending on the severity of dehydration and individual circumstances.

• For mild to moderate dehydration, oral rehydration solutions (ORS) are recommended 2, 3, 4.
• The World Health Organization (WHO) ORS, which contains glucose and reduced osmolarity, is a preferred option for rehydration in diarrheal illness 2.
• Other oral rehydration solutions, such as Pedialyte and Infalyte, have also been found to be effective in treating dehydration in infants and children 3, 5.
• For adults with viral gastroenteritis, solutions like Gatorade, Pedialyte, and a New Oral Rehydration Solution (N-ORS) have been shown to be effective in correcting dehydration and improving bowel symptoms 5.
• Sport drinks, juice, soft drinks, and chicken broth are not recommended for severe dehydration but can be considered for patients with no or mild dehydration 2.
• It is essential to avoid excessive intake of sodium-free fluids to prevent exercise-induced hyponatremia 2.

Key Considerations

When selecting a fluid for rehydration, consider the following factors:

• The severity of dehydration
• The presence of underlying medical conditions
• The individual's age and activity level
• The need for electrolyte replacement
• The palatability of the fluid 5

Oral Rehydration Therapy

Oral rehydration therapy (ORT) is an effective treatment for mild to moderate dehydration in children and can be used more frequently instead of intravenous rehydration therapy 4, 6.

• ORT allows for holistic care, enhancing client comfort and autonomy 4.
• It can be performed at home, reducing hospital stays and allowing for quicker initiation of treatment compared to IV therapy 4.