The use of isotonic sodium chloride in the early treatment of cholera diarrhea: the Peruvian experience

Due to the limited supply in Peru of polyelectrolitic solutions recommended for the initial treatment of cholera diarrhea, a massive amount of isotonic sodium chloride solution was used during the recent cholera epidemic. This treatment proved adequate based on the low mortality rate, which compared favorably with international mortality rate reports. A preliminary observation of six adult Peruvian patients hospitalized with hypovolemic shock and metabolic acidosis secondary to cholera diarrhea showed remission of hypovolemic manifestations and significant improvement of serum bicarbonate, pCO₂, and base excess after rapid intravenous infusion of a solution of isotonic sodium chloride. This intravenous solution seems adequate as the initial intravenous fluid for patients with severe cholera, as a logical alternative to currently recommended polyelectrolitic solutions containing bicarbonate or lactate.