The hydration plans from WHO (World Health Organization) are defined according to this entity as a set of behaviors and measures to be followed whose purpose is to restore and maintain the hydroelectric balance of an individual. They are also called rehydration plans..
These plans are well described and differentiated. They take into account in particular the hydration status of the patient through characteristic signs or symptoms. There are many diseases, syndromes, conditions and clinical entities capable of altering the hemodynamics of the human body due to their pathophysiological characteristics..
At this point is when the importance of hydration plans is denoted, since they prevent dehydration early or treat it immediately, thus avoiding the evolution to states in which the life of the individual is compromised..
Fluids are the fundamental component of the human body, they represent 70% of the total body weight of an individual under normal conditions. However, body fluids are separated within the human anatomy into compartments.
The compartments are named in relation to whether they are inside or outside cells. The two largest compartments are the intracellular compartment and the extracellular compartment..
The intracellular compartment has two thirds of the total body water; on the other hand, the extracellular compartment has the remaining third.
At your sight; the extracellular compartment is divided into two subcompartments called intravascular (25% extracellular fluids) and interstitial (75% extracellular fluids).
Oral rehydration salts (ORS) are a set of salts and / or substances used in rehydration plans according to the WHO for the treatment of dehydration.
The WHO describes ORS as the fastest, safest and cheapest way to prevent and treat electrolyte imbalances. Its most common presentation is in the form of envelopes, inside which are the salts in powder form. These are diluted in a certain amount of water.
Many different laboratories around the world release ORS, but regardless of source or brand, oral rehydration salts should be made up of the following elements:
In case of not having ORS available to apply the rehydration plans that include them, the WHO suggests using this recipe: dilution in a liter of water of 6 level tablespoons of sugar and a tablespoon of salt. Some doctors in underdeveloped countries have incorporated the juice of a lemon or ¼ teaspoon of bicarbonate.
However, this last recipe is very controversial and its use has been relegated to cases of extreme need, since it is quite imprecise and on certain occasions it can generate serious complications, such as hyperosomolar coma in pediatric patients..
The name of crystalloids is attributed to liquids that in medicine are used to restore or supply the needs of water and electrolytes of the human body..
The most widely used today are 0.9% saline solutions (isotonic), 3% saline solution (hypertonic) and 0.45% saline solution (hypotonic), lactated ringer's solution and dextrose solution..
For their part, colloid solutions in medicine are those whose oncotic pressure is similar to the oncotic pressure of plasma.
For this reason they are used to retain water in the intravascular space; that is why they are called plasma expanders. The most widely used today is albumin.
Dehydration is defined as a water and electrolyte imbalance whose multifactorial genesis is attributable to two main factors: decreased intake and increased fluid loss. In the context of fluid loss, two mechanisms are described:
Fluid that is excreted through urine, feces, or sweat. They are quantifiable.
Fluid that is lost through respiration (lungs) or evaporation (skin). It has the characteristic that it is not measurable.
Depending on the severity of dehydration, it will be expressed with a specific symptomatology. From there the following classification arises:
In this type of dehydration, the percentage loss of body fluids is < 6 %. Su examen clínico generalmente tiende a la normalidad; el paciente podría tener sed.
In this type of dehydration, the percentage loss of fluids is> 6% to 30%, it presents a decrease in the turgor and elasticity of the skin, sunken eyes, dry mucous membranes, irritability, nausea, vomiting and great thirst.
Percentage loss of body fluids> 30%, drowsy, lethargic patient, sunken eyes, dry mucous membranes, tachycardia, hypotension, positive fold sign and anuria. General hemodynamic compromise.
The World Health Organization classifies rehydration plans depending on the severity of the dehydration state. These plans are applied to individuals with a potentially dehydrating illness or syndrome, such as acute diarrhea..
Patient who tolerates the oral route. If it is younger than 2 years, apply 50 to 100 cc of oral rehydration salts for each liquid evacuation that presents.
If you are older than 2 years, you should consume 100 to 200 cc of ORS for each liquid evacuation.
Plan A applies to individuals who do not have any symptoms or to patients with mild dehydration.
Oral rehydration salts should be administered by virtue of 50 to 100 cc per kg of body weight in a time of 4 to 6 hours, and then reassess.
Plan B applies to individuals with moderate dehydration symptoms who tolerate the oral route..
It is applied to individuals with symptoms of severe dehydration or to individuals with moderate dehydration who cannot tolerate the oral route..
25 cc per kg of weight should be administered intravenously of physiological solution in the first hour, and the same amount must be repeated in the second and third hours. Then it should be reevaluated.
50 cc per kg of weight should be administered intravenously of physiological solution in the first hour, 25 cc of solution per kg of weight in the second hour and the latter repeated during the third hour. Then reevaluate.
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