ABSTRACT
The development of oral rehydration fluid for the treatment of cholera and other diarrhoeal diseases has been regarded as one of the most important medical advances of the last century. This article summarises information on how this achievement was made possible. The development is traced from the historical empiric use of oral fluids for treating diarrhoea, to physiologic studies in animals that defined how glucose and sodium were coupled in absorption by the small intestine and finally, to the use of this knowledge in developing the simple effective solutions that were adopted by WHO as the mainstay of diarrhoeal therapy worldwide.
Subject(s)
Animals , Cholera/history , Diarrhea/history , Fluid Therapy/history , History, 20th Century , History, Ancient , Humans , India , Intestinal Absorption/physiologySubject(s)
Acute Disease , Diarrhea/history , Fluid Therapy/history , History, 20th Century , India , Societies, Medical/historySubject(s)
Americas , Animals , Asia , Cholera/history , Diarrhea/history , Europe , Fluid Therapy/history , History, 20th Century , Humans , Rehydration Solutions/historyABSTRACT
The review of the current status and implementation of Oral Rehydration Therapy at the community level have been presented in this communication with special emphasis on its development, ORS access rate, ORS use rate and home available fluids. The global ORS supply has gone up an increased eleven folds since 1981. Similarly the ORS access rate has also increase from 46% to 68% in 1991. However, the global ORS use rate was low (21%). The major constraints during ORT implementation which have been reported by several scientists are also discussed.
Subject(s)
Asia , Clinical Trials as Topic , Developing Countries , Diarrhea/therapy , Fluid Therapy/history , History, 20th Century , Humans , National Health Programs/organization & administration , Rehydration Solutions/therapeutic useABSTRACT
A fin de establecer un tratamiento efectivo para rehidratar lactantes que padecian diarrea aguda, diversos investigadores (1940 Diarrow y colaboradores; 1953 Chatterjee; Nieneghello, De la Torre y Larracilla y Ceballos; en 1963 Schedl y Clifton) se dieron a la tarea de recopilar datos y a establecer o sugerir el empleo de soluciones. Como resultado de esta tarea la OMS recomendó, desde 1971, una solución para hidratación oral que contenia o contiene consentraciones casi equivalentes de sodio (90 mmo/L) y glucosa (111 mmol/L) para ser utilizada en el manejo de niños con diarrea aguda, está solución contenia, además, cloro, potasio y bicarbonato. La absorción acoplada de glucosa y sodio, se demostró, favorecía la absorción de agua, permitiendo obtener balances hidrícos positivos que posibilitan la corrección de la deshidratación. La adición de bicarbonato a las soluciones infundidas tuvo un efecto significativo sobre la absorción de sodio y agua en el yeyuno. Asimismo el pH es un factor que tiene relación con la substancia ingerida en la hidratación. Finalmente es importante mantener las relaciones equimolares cercanas de la glucosa y el sodio en las soluciones de hidratación oral. Por otra parte, experimentalmente, se ha observado que la remoción del cloro da lugar a una disminución de la absorción de sodio, en tanto que la falta de sodio disminuye el movimiento de cloro. Todos los elementos señalados son factores que interviene en la rehidratación o que su deficiencia o exceso es un signo o causa de deshidratación
Subject(s)
Diarrhea/therapy , Fluid Therapy/history , Fluid Therapy/analysis , MexicoABSTRACT
Faz-se uma revisäo sobre hidrataçäo oral nas diarréias agudas, considerando-se primordialmente os aspectos históricos e fisiológicos deste procedimento, que apesar de näo ser uma inovaçäo em Medicina, passou por várias fases de aperfeiçoamento, sendo hoje uma das maiores armas no controle da desidrataçäo, principalmente nos países subdesenvolvidos