Resomal (Rehydration Solution for Malnutrition): Preparation, Composition and Use

Photo of Resomal (Rehydration Solution for Malnutrition): Preparation, Composition and Use

Resomal means Rehydation Solution for Malnutrition. It is a form of Oral Rehydration Solution (ORS) used for correcting dehydration specifically in malnourished people especially children. Resomal is prepared in such a way that it has low Sodium content compared to the normal ORS used for correction of dehydration in diarrhea and high potassium because all malnourished children have high sodium content in their blood and low potassium, hence they are given Resomal and not ORS because the latter has higher sodium content which may cause a condition known as Hypernatraemia in the malnourished child.

The new Resomal comes in 42g sachet as a powder that should be dissolved in 1 litre of water. It has a shelf life of 3 years (36 months). In the absence of this or when managing severe acute malnutrition in rural settings, you can roughly prepare resomal using the WHO-ORS which is most available even in rural settings. The method of preparation is outlined below.

Composition of 1 litre of Resomal
Contents of Resomal
Amounts (in mmol/L)
Glucose
125
Chloride
70
Sodium
45
Potassium
40
Citrate
7
Magnesium
3
Zinc
0.3
Copper
0.045
Total Osmolarity of 1 Litre of Resomal
300 mmol/L

Preparation of Resomal

The sources of electrolytes and mineral used in resomal are as follows:

Contents of Resomal

  1. Potassium is gotten from Potassium Chloride
  2. Magnesium is from Magnesium Chloride
  3. Zinc is gotten from Zinc Acetate
  4. Copper is from copper sulphate
  5. Water
  6. Citrate is from Tripostassium Citrate dihydrate

Procedure for preparation

  1. Dissolve 1 packet of standard WHO ORS in 2 litres of water (this is only done when using ORS, for standard premixed resomal satchet, it is normally 1 litre)
  2. Add 50g of glucose
  3. Add 40ml of commercial mineral and vitamin mix solution (the mineral solution should contain Zinc, Magnesium and Copper). An example of this is WellKid
Comparison of Resomal and WHO-ORS with their composition
Comparison of Resomal and WHO-ORS with their composition

 

When to stop using Resomal

Use of Resomal can be stopped when the child is:

  1. No longer thirsty
  2. When urine is passed
  3. The pulse is normal and full volume
  4. Other signs of dehydration have disappeared

This solution should never be prepared at home and should not be given to well-nourished people as it may cause electrolyte imbalance in them. It is not recommended for treatment of dehydration due to diarrhea (such as in cholera).