Effects of oral rehydration solution-based prophylactic sodium supplementation on clinical outcomes in pediatric pneumonia: A randomized controlled trial

doi:10.5409/wjcp.v14.i4.113328

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World Journal of Clinical Pediatrics

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2219-2808

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Randomized Controlled Trial

World J Clin Pediatr. Dec 9, 2025; 14(4): 113328
Published online Dec 9, 2025. doi: 10.5409/wjcp.v14.i4.113328

Effects of oral rehydration solution-based prophylactic sodium supplementation on clinical outcomes in pediatric pneumonia: A randomized controlled trial

Hoda Atef Abdelsattar Ibrahim, Mohamed Agha, Marwa Taha

Hoda Atef Abdelsattar Ibrahim, Division of Pediatric Clinical Nutrition, Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo 12613, Egypt

Mohamed Agha, Complementary Medicine Department, National Research Centre, Dokki, Giza 12622, Egypt

Marwa Taha, Department of Pediatrics, Mataria Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Cairo 11756, Egypt

Author contributions: Atef Abdelsattar Ibrahim H performed visualization, conceptualization, formal statistical data analysis, interpretation, and manuscript drafting, writing, reviewing, and editing; Agha M performed reviewing and editing; and Taha M provided resources and contributed to conceptualization, study design, data collection, interpretation, and manuscript review and editing; all the authors read and approved the final manuscript.

Institutional review board statement: Participant consent was obtained in accordance with the Institutional Review Board. The research was revised and approved by the Research Ethics Committee of the General Organization of Teaching Hospitals and Institutes (GOTHI) on June 12, 2024 (IRB number: HM000174). The study posed no injury or harm to the recruited children. We also conducted our research in accordance with the Declaration of Helsinki.

Clinical trial registration statement: The trial was registered with Clinical Trial Registration ID: NCT06951347 in April 2025 (https://clinicaltrials.gov/study/NCT06951347). Registration preceded the first patient enrollment in accordance with CONSORT/ICMJE requirements.

Informed consent statement: Parents/Legal guardians provided informed written consent before participation in the study. When culturally or legally needed, the permission of both parents was obtained in line with institutional policy.

Conflict-of-interest statement: All authors declare that there are no conflicts of interest.

CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.

Data sharing statement: The raw data are available from the corresponding author upon reasonable request.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Hoda Atef Abdelsattar Ibrahim, MD, Division of Pediatric Clinical Nutrition, Department of Pediatrics, Faculty of Medicine, Cairo University, No. 1 Gamaa Street, Giza, Cairo 12613, Egypt. hodaibrahim424@gmail.com

Received: August 26, 2025
Revised: September 16, 2025
Accepted: October 17, 2025
Published online: December 9, 2025
Processing time: 70 Days and 12.5 Hours

Abstract

BACKGROUND

Hyponatremia is a prevalent and serious electrolyte imbalance in pediatric pneumonia and is linked to increased disease severity and adverse outcomes. Oral rehydration solution (ORS) is an available, inexpensive, safe, and ready-to-use oral solution that can supplement sodium in such cases.

AIM

To assess the impact of prophylactic sodium supplementation via ORS on clinical and hospital outcomes in infants and children admitted with pneumonia.

METHODS

A randomized, interventional controlled trial was conducted on 140 infants and children admitted with pneumonia (70 per group). The primary outcome was hospital length of stay, with secondary outcomes including serum sodium and potassium levels, clinical respiratory scores, modified shock index, and nutritional/inflammatory markers. The hospital length of stay and both the laboratory and clinical parameters of the interventional and control groups were compared.

RESULTS

The hospital stay was longer in the control group than in the intervention group (P value = 0.001; effect size = 0.59). Clinical respiratory scores on day 4 were significantly lower in the intervention group than in the control group (P value = 0.001). Sodium levels were significantly lower in the control group than in the intervention group at discharge (P value = 0.002).

CONCLUSION

Prophylactic oral sodium supplementation through ORS may have a health-promoting effect on infants and children admitted with pneumonia.

Keywords: Oral rehydration solution; Hyponatremia; Pediatric pneumonia; Randomized controlled trial; Length of stay; Egypt

Core Tip: Our study outlined the possible use of oral rehydration solution (ORS) to provide prophylactic sodium supplementation in infants and children with pneumonia. Sodium and potassium supplementation may improve clinical respiratory manifestations in infants and children with pneumonia. ORS supplementation may be a prophylactic therapy for prolonged hospitalization in infants and children with pneumonia.