Elc9.0

Electrolyte Complex Research

43 peer-reviewed studies · Evidence score: 9/10

1

Parental beliefs in and attitudes toward teething signs and symptoms: A systematic review

Pereira TS et al. • International journal of paediatric dentistry (2023)

The majority of parents believed in at least one sign or symptom associated with teething, and only few of them would do nothing or just wait for the signs or symptoms to pass, with no difference among countries (Protocol doi: 10.17605/OSF.IO/S2KZ3).

The majority of parents believed in at least one sign or symptom associated with teething, and only few of them would do nothing or just wait for the signs or symptoms to pass, with no difference among countries (Protocol doi: 10.17605/OSF.IO/S2KZ3).
Further research warranted to confirm findings

Systematic Reviewn=524

2

Racecadotril for acute diarrhoea in children

Liang Y et al. • The Cochrane database of systematic reviews (2019)

Racecadotril seems to be a safe drug but has little benefit in improving acute diarrhoea in children under five years of age.

Racecadotril may reduce the risk of rehydration failure (RR 0.41, 95% CI 0.13 to 1.23; 2 RCTs, 192 participants; low-certainty evidence).
Length of hospital stay was similar in two studies measuring this, and overall there was no evidence that racecadotril increased overall rate of adverse events (RR 0.90, 95% CI 0.66 to 1.22; 5 RCTs, 688 participants; low-certainty evidence).
Racecadotril seems to be a safe drug but has little benefit in improving acute diarrhoea in children under five years of age.

Meta-Analysisn=1,140

3

Polymer-based oral rehydration solution for treating acute watery diarrhoea

Gregorio GV et al. • The Cochrane database of systematic reviews (2016)

Polymer-based ORS shows advantages compared to glucose-based ORS (at ≥ 310 mOsm/L).

Polymer-based ORS may decrease mean stool output in the first 24 hours by 24 mL/kg (mean difference (MD) -24.60 mL/kg, 95% CI -40.69 to -8.51; one trial, 99 participants, low quality evidence).
The average duration of diarrhoea may be reduced by eight hours (MD -8.24 hours, 95% CI -13.17 to -3.30; I² statistic = 86%, five trials, 364 participants, low quality evidence) with polymer ORS but results are heterogeneous.
Limited trials showed no observed difference in the risk of unscheduled use of intravenous fluid (RR 0.66, 95% CI 0.43 to 1.02; I² statistic = 30%; four trials, 376 participants, very low quality evidence), vomiting (very low quality evidence), and hyponatraemia (very low quality evidence).

Meta-Analysisn=4,284

4

Antimicrobial drugs for treating cholera

Leibovici-Weissman Y et al. • The Cochrane database of systematic reviews (2014)

In treating cholera, antimicrobials result in substantial improvements in clinical and microbiological outcomes, with similar effects observed in severely and non-severely ill patients.

Antimicrobials versus placebo or no treatment Overall, antimicrobial therapy shortened the mean duration of diarrhoea by about a day and a half compared to placebo or no treatment (MD -36.77 hours, 95% CI -43.51 to -30.03, 19 trials, 1013 participants, moderate quality evidence).
In treating cholera, antimicrobials result in substantial improvements in clinical and microbiological outcomes, with similar effects observed in severely and non-severely ill patients.
Azithromycin and tetracycline may have some advantages over other antibiotics.

Meta-Analysisn=4,623

5

Systematic review with meta-analysis: ondansetron for vomiting in children with acute gastroenteritis

Tomasik E et al. • Alimentary pharmacology & therapeutics (2016)

Compared with placebo, ondansetron administration for vomiting in children with acute gastroenteritis can improve the efficacy of oral rehydration therapy.

Treatment with ondansetron compared with placebo increased the chance for vomiting cessation up to 1 h after drug administration, relative risk, RR, 1.49 (95% confidence interval 1.17-1.89), but there was no difference between the groups after 4, 24 and 48 h.
Compared with placebo, ondansetron administration for vomiting in children with acute gastroenteritis can improve the efficacy of oral rehydration therapy.
Further research warranted to confirm findings

Meta-Analysisn=1,215

6

Gastroenteritis Therapies in Developed Countries: Systematic Review and Meta-Analysis

Freedman SB et al. • PloS one (2015)

There is a paucity of patient-centered outcome evidence to support many interventions.

ORT: Compared with intravenous rehydration, hospitalization (RR 0.80, 95%CI 0.24, 2.71) and emergency department return visits (RR 0.86, 95%CI 0.39, 1.89) were similar.
Antiemetics: Fewer children administered an antiemetic required intravenous rehydration (RR 0.40, 95%CI 0.26, 0.60) While the data could not be meta-analyzed, three studies reported that ondansetron administration does increase the frequency of diarrhea.
Probiotics: No studies reported on the primary outcome, three studies evaluated hospitalization within 7 days (RR 0.87, 95%CI 0.25, 2.98).

Meta-Analysisn=4,444

7

Racecadotril for childhood gastroenteritis: an individual patient data meta-analysis

Lehert P et al. • Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (2011)

Dehydration level and Rotavirus at baseline are essential adjustments to compare treatments.

The proportion of recovered patients was higher in racecadotril groups compared with placebo, Hazard Ratio HR=2.04, 95% CI (1.85; 2.32), p<0.001.
Dehydration level and Rotavirus at baseline are essential adjustments to compare treatments.
Further research warranted to confirm findings

Meta-Analysisn=1,384

8

Oral rehydration salt solution for treating cholera: ≤ 270 mOsm/L solutions vs ≥ 310 mOsm/L solutions

Musekiwa A et al. • The Cochrane database of systematic reviews (2011)

In people with cholera, ORS ≤ 270 is associated with biochemical hyponatraemia when compared with ORS ≥ 310, but there are no differences in terms of other outcomes.

We found no statistically significant difference in the need for unscheduled intravenous infusion.
In people with cholera, ORS ≤ 270 is associated with biochemical hyponatraemia when compared with ORS ≥ 310, but there are no differences in terms of other outcomes.
Although this risk does not appear to be associated with any serious consequences, the total patient experience in existing trials is small.

Meta-Analysisn=718

9

Sodium intake for athletes before, during and after exercise: review and recommendations

Turner MJ et al. • Performance Nutrition (2025)

Exercise performance appears improved by sodium intake when fluid intake is greater in the sodium trial.

Sodium benefits linked to improved hydration
No evidence athletes need more daily sodium
Pre-exercise sodium loading can benefit fluid retention

Systematic Review

10

Oral Rehydration Beverages for Treating Exercise-Associated Dehydration: A Systematic Review, Part II. The Effectiveness of Alternatives to Carbohydrate-Electrolyte Drinks

De Brier N et al. • Journal of athletic training (2025)

Consuming skim or low-fat cow's milk without additional food intake as compared with water appears to improve volume/hydration status in people with exercise-induced dehydration.

Consuming skim or low-fat cow's milk without additional food intake as compared with water appears to improve volume/hydration status in people with exercise-induced dehydration.
However, evidence is of very low certainty and should be interpreted with caution.
Further research warranted to confirm findings

Systematic Review

11

Systematic review on management of high-output enterostomy in children: An urgent call for evidence

Stoop TF et al. • Journal of pediatric gastroenterology and nutrition (2024)

This first systematic review on management of high-output enterostomy in children revealed that any evidence on the primary and secondary outcomes is lacking.

This first systematic review on management of high-output enterostomy in children revealed that any evidence on the primary and secondary outcomes is lacking.
Till more evidence is available, a systematic and multidisciplinary step-up approach is needed.
Therefore, a therapeutic work-up is proposed that could guide the care.

Systematic Review

12

Low-osmolarity oral rehydration solution for childhood diarrhoea: A systematic review and meta-analysis

Zubairi MBA et al. • Journal of global health (2024)

Our findings suggest that LORS should continue to be recommended in children under the age of 10 years with acute watery or persistent diarrhoea and upholds the current WHO recommendations.

There was a comparable effect on the number of patients cured within five days, treatment failure, and frequency of unscheduled intravenous therapy (risk ratio (RR) = 0.77; 95% CI = 0.72, 9.38; low certainty of evidence).
Our findings suggest that LORS should continue to be recommended in children under the age of 10 years with acute watery or persistent diarrhoea and upholds the current WHO recommendations.
Further research warranted to confirm findings

Meta-Analysis

13

Hydration Methods for Cisplatin Containing Chemotherapy: A Systematic Review

Sikking C et al. • The oncologist (2024)

The hydration scheme of cisplatin should be short and consist of a relatively small amount of volume.

The hydration scheme of cisplatin should be short and consist of a relatively small amount of volume.
The scheme should include mannitol and magnesium supplementation.
Head-to-head studies are needed to investigate the safety of furosemide compared with mannitol and the dose of mannitol and magnesium.

Systematic Review

14

The efficacy of fermented foods in the treatment and management of diarrhoeal diseases: A systematic review and meta-analysis

Olayanju A et al. • Nutrition and health (2023)

More high quality research needs to be undertaken to investigate the efficacy of fermented food as an effective alternative to ORS as a potential WHO recommendation for management of diarrhoeal disease.

Meta-analysis showed that compared to control, consumption of fermented foods significantly reduced mean duration of diarrhoea, -0.61 days; (95% CI, -1.04, -0.18); length of hospitalization, -0.35 days (95% CI, -0.69, -0.02); but not mean daily frequency of stool -2.00 (95% CI,-7.03, 3.04).
Results: Seven RCTs were included.
Conclusion: Limited available evidence suggests that consumption of fermented foods may help reduce duration and severity of symptoms as a treatment of diarrhoea.

Meta-Analysis

15

Antibiotic resistance trends for common bacterial aetiologies of childhood diarrhoea in low- and middle-income countries: A systematic review

Neupane R et al. • Journal of global health (2023)

Resistance to inexpensive antibiotics for treatment of invasive diarrhoea in children under ten years is widespread (although data on 6- to 10-year-old children are limited), and resistance rates to fluoroquinolones and later-generation cephalosporins are increasing.

Resistance rates for ampicillin, co-trimoxazole, and chloramphenicol for Shigella in the AFR started at an alarmingly high rate ( ~ 90%) in 2006 and fluctuated over time.
Resistance to inexpensive antibiotics for treatment of invasive diarrhoea in children under ten years is widespread (although data on 6- to 10-year-old children are limited), and resistance rates to fluoroquinolones and later-generation cephalosporins are increasing.
A strong regional surveillance system is needed to carefully monitor trends in antibiotic resistance, future studies should include school-aged children, and interventions are needed to reduce inappropriate use of antibiotics for the treatment of community-acquired, non-invasive diarrhoea.

Systematic Review

16

The effect of oral hydration on the risk or aspiration and hemodynamic stability before the induction of anesthesia: A systematic review and meta-analysis

Oshima S et al. • Journal of clinical anesthesia (2018)

Our systematic review indicates that oral rehydration therapy does not increase the risk of aspiration or vomiting.

There was no aspiration or vomiting in either group [3 studies, 428 patients, RD 0 (95% CI -0.01 to 0.01), I2 = 0%].
ORS administration caused no significant difference in gastric volume [4 studies, 486 participants, MD -1.12 ml (95% CI -5.61 to 3.36), I2 = 62%] or gastric pH [4 studies, 486 participants, MD -0.03. (95% CI -0.37 to 0.31), I2 = 0%] compared with the control group.
In contrast, ORS resulted in a significant reduction in SVV during the anesthesia induction period [3 studies, 118 participants, MD -3.02 (95% CI -5.44 to -0.59), I2 = 65%].

Meta-Analysisn=486

17

Zinc supplementation for treating diarrhea in children: a systematic review and meta-analysis

Galvao TF et al. • Revista panamericana de salud publica = Pan American journal of public health (2013)

Oral zinc supplementation significantly decreases diarrhea duration and has a greater effect on malnourished children.

Zinc was beneficial for reducing the duration of diarrhea in hours (mean difference [MD] = -20.12, 95% confidence interval [CI] = -29.15 to -11.09, I² = 91%).
The effect was greater in malnourished children (MD = -33.17, 95% CI = -33.55 to -27.79, I² = 0%).
Oral zinc supplementation significantly decreases diarrhea duration and has a greater effect on malnourished children.

Meta-Analysisn=41

18

Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children

Hartling L et al. • The Cochrane database of systematic reviews (2006)

Although no clinically important differences between ORT and IVT, the ORT group did have a higher risk of paralytic ileus, and the IVT group was exposed to risks of intravenous therapy.

There were more treatment failures with ORT (RD 4%, 95% confidence interval (CI) 1 to 7, random-effects model; 1811 participants, 18 trials; NNT = 25).
Shorter hospital stays were reported for the ORT group (WMD -1.20 days, 95% CI -2.38 to -0.02 days; 526 participants, 6 trials).
Although no clinically important differences between ORT and IVT, the ORT group did have a higher risk of paralytic ileus, and the IVT group was exposed to risks of intravenous therapy.

Meta-Analysisn=1,811

19

Travellers' diarrhoea

Heather CS • BMJ clinical evidence (2015)

In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (empirical), antibiotics plus antimotility agents, antimotility agents, bismuth subsalicylate, diet, oral rehydration solutions, and racecadotril for travellers' diarrhoea.

Systematic review examining Electrolyte Complex efficacy
Further research warranted to confirm findings

Systematic Reviewn=24

20

Diarrhoea in adults (acute)

Gottlieb T et al. • BMJ clinical evidence (2011)

We performed a GRADE evaluation of the quality of evidence for interventions.

Systematic review examining Electrolyte Complex efficacy
Further research warranted to confirm findings

Systematic Review

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