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Pediatric Hypovolemic Shock  Michael J. Hobson and Ranjit S. Chima
Pediatric Hypovolemic Shock Michael J. Hobson and Ranjit S. Chima

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Oral rehydration therapy



Oral rehydration therapy (ORT) is a fluid replacement strategy used to prevent or treat dehydration. Dehydration is most commonly caused by diarrhea. It involves drinking water with modest amounts of sugar and salt added, while continuing to eat. When diarrhea is severe or long-lasting, the therapy also includes supplemental zinc. Caretakers are taught the signs of dehydration and/or worsening dehydration. The World Health Organization and UNICEF specify indications, preparations and procedures for ORT.Vomiting seldom prevents successful rehydration since much of the fluid is still absorbed. If the patient vomits, the World Health Organization (WHO) recommends taking a pause of five to ten minutes and then restarting the solution more slowly. For example, a child under two can be given a teaspoonful of fluid every two to three minutes.Since its introduction and development for widespread use in the latter part of the 20th century, oral rehydration therapy has decreased human deaths from dehydration in vomiting and diarrheal illnesses, especially in cholera epidemics occurring in children. It represents a major advance in global public health. It is on WHO's List of Essential Medicines, a list of the most important medication needed in a basic health system.Prior to the introduction of ORT, death from diarrhea was the leading cause of infant mortality in developing nations. Between 1980 and 2006, the introduction of ORT is estimated to have decreased the number of infant deaths, worldwide, from 5 to 3 million per year. However, in 2008, diarrhea remained the second most common cause of death in children under five years (17 percent), (after pneumonia (19 percent)). Moreover, by the same year, the use of ORT in children under five had declined.In situations where an oral rehydration solution (ORS) is not available, homemade solutions are sometimes used. However, there is currently insufficient evidence to recommend usage of these homemade solutions.
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