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Intestinal failure
PMO-027 Variability in the content of oral rehydration solution used in intestinal failure may render it ineffective
  1. A Culkin
  1. St Mark's Hospital, Harrow, UK

Abstract

Introduction The focus of treatment in patients with intestinal failure (IF) is to reduce intestinal losses, therefore preventing dehydration and electrolyte disturbances. This is achieved by restricting oral fluid intake and using an oral rehydration solution (ORS) with a sodium content of 90 mmol/l. Compliance can be poor and it is usual to allow patients to add a small amount of flavouring to the ORS. Research has indicated that this reduces the sodium content rendering the solution no longer suitable.1 We aimed to investigate the variability in composition and the effect of adding flavouring.

Methods A sample of ORS made up by the ward staff was analysed for sodium, glucose and osmolality daily over 5 days. The ORS from day 5 was then used and a further five samples were analysed after patients has added their preferred type and amount of flavouring. The mean and SD were calculated.

Results There was a large variability in the sodium (mean 162±44 mmol/l, range 100–224) and glucose (105±27 mmol/l, range 85–150) content and the osmolarity (413±109 mmol/l) of the ORS made on the ward over the 5-day period. The addition of the flavourings decreased the sodium content (mean of 33±14 mmol/l, range 10–49) and increased the glucose content (mean 93±59 mmol/l, range 7–164) of the ORS. The osmolality also increased (mean 229±113 mOsmol, range 23–376).

Conclusion There was considerable variability in the content when ORS are made up on the hospital ward. Adding flavourings may render the ORS less effective by reducing the sodium and increasing the glucose and osmolarity. The results indicate a need for a pre-flavoured packaged ORS with a sodium content of 90 mmol/l.

Abstract PMO-027 Table 1

Competing interests None declared.

Reference 1. Williams J, et al. Effect of flavouring on isotonic solutions for short bowel syndrome. Gut 2003;52(Suppl 1):A10.

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