ReSoMal
Oral rehydration solution for severe acute malnutrition

Recommendations for use
- The quantity to be given depends on the weight of the patient. Between 70 and 100 ml per kilo are usually sufficient to re-establish normal hydration (on average, one sachet of ReSoMal will, therefore, be enough to rehydrate four children who weigh 7 kg).
- The exact quantity depends on what the child drinks, the volume of continuing loss (stools, vomit) and the possible appearance of signs of hyperhydration (particularly symptoms of cardiac insufficiency).
Packaging and conservation
- Primary packaging : ReSoMal is delivered in sachets containing 84 g of powder, which can be used up to 36 after the date of manufacture. One sachet can reconstitute two litres of rehydration liquid.
- Secondary packaging : Cartons of 130 sachets (gross weight : 12.02 kg ; net weight : 10.92 kg).
- Palletisation : Pallets with 48 cartons (gross weight : 596.96 kg).
- Where possible, to be stored in a dry, cool area, at a temperature of less than 30°C.
ReSoMal is a powder for the preparation of an oral rehydration solution (ORS) exclusively for people suffering from severe acute malnutrition. It must be used under medical supervision in therapeutic feeding centres, and must not be given directly to families.
Main characteristics, target population and benefits obtained
Seriously malnourished children commonly suffer from a deficiency of potassium and various other mineral deficiencies, as well as from an abnormally high level of sodium. In the event of rehydration, it is therefore necessary to give them a specific ORS containing less sodium, more potassium and more magnesium, zinc and copper.
ReSoMal was developed to meet this specific need. It must not be given to well-nourished people or those suffering from cholera (in these cases standard ORSs, which conform to the WHO formula, must be used). It was specially designed for the treatment of dehydration in people suffering from severe acute malnutrition.
References
- La prise en charge de la malnutrition sévère : Manuel à l’usage des médecins et autres personnels de santé à des postes d’encadrement (Management of severe malnutrition: a manual for physicians and other senior health workers), OMS, 1999
http://www.who.int/nutrition/publications/severemalnutrition/9241545119/en/index.html - Efficacy and safety of a modified oral rehydration solution (ReSoMal) in the treatment of severely malnourished children with watery diarrhea. N.H Alam and al. The Journal of Pediatrics, 2003.
http://www.jpeds.com/article/S0022-3476%2803%2900500-6/abstract - Water and electrolyte salvage in an animal model of dehydration and malnutrition. Sufia Islam at al. Journal of Pediatric Gastroenterology and Nutrition, 2004 - Volume 38 - Issue 1
http://journals.lww.com/jpgn/Abstract/2004/01000/Water_and_Electrolyte_Salvage_in_an_
Animal_Model.9.aspx - Simplifying the WHO Guidelines for Managing Severe Malnutrition Ann Ashworth. India Pediatrics, Vol. 46, March 2009
http://medind.nic.in/ibv/t09/i3/ibvt09i3c.shtml
