Tratamiento de la deshidratación diarreica mediante el suministro de líquidos por vía endovenosa, con especial referencia a la situación en la América Latina
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1) The choice of a solution for intravenous rehydration is in many clinics based on clinical estimates of the patient's osmotic disturbance and the severity of acidosis. Even when biochemical measurements are possible, however -and these correlate poorly with the clinical assumptions- the relevance of this knowledge to appropriate therapy is not known. Recommended solutions vary widely, from alkaline multielectrolyte mixtures with a concentration of 300 mOsm/L ("isotonic") or even higher to one-third or one-half isotonic solutions of sodium chloride. The simpler, less concentrated solutions are theoretically preferable in that they provide more "free water". They are being used with good results in both "hypertonic" and "hypotonic" dehydration by an increasing number of clinics2) Since most children with diarrhea are malnourished and many have associated infections, several factors may contribute to therapeutic success or failure. If the relative contribution of each of these factors could be more precisely defined, beneficial changes in therapeutic emphasis might ensue. First, however, objective, individualized estimates of dehydration and malnutrition are needed. Dehydration should be measured in terms of weight lost or regained rather than by clinical appraisal. The estimate of malnutrition should if possible be based on comparison of the patient's weight with his own ...(AU)
Intravenous fluid therapy of diarreheal dehidaration with special reference to Latin America
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