The place of oral rehydration solutions in the structure of ERAS protocols (literature review)

P.I. Bihniak, M.L. Homon, K.Yu. Kreniov


The article provides a comprehensive assessment of the use of oral rehydration therapy in various fields of medicine, the place of oral rehydration solutions in the structure of Enhanced Recovery after Surgery (ERAS) protocols and their impact on the correction of water-electrolyte disorders, since the correction of water-electrolyte balance is a mandatory component of perioperative intensive care of surgical patients and is included in European ERAS protocols. The article describes the basic biological mechanisms of support and sustainability of homeostasis, the main types of its disorders. The water environment is about 60 % in the body of an adult. The functions of water are to participate in the formation of intracellular structures, to form the spatial conformations of protein molecules (secondary, tertiary), to participate in chemical reactions of hydrolysis, hydration, oxidation, recovery, etc., transport function and excretion of decay products. An integral part of water exchange is the exchange of electrolytes, which creates a stable homeostasis of the internal environment with the ability of autoregulation with significant fluctuations in environmental conditions, toxic or viral-bacterial influences. The water and electrolyte balances of the body are closely interrelated. The stable equilibrium of the osmotic pressure of blood plasma, interstitial and intracellular fluid is one of the main conditions of normal cell life. Briefly characterizing the major ions, it can be pointed out that the potassium content in the body is about 160 g. It is the main intracellular cation, the main depot of which is the muscle tissue. It is involved in maintaining the osmotic pressure and acid-base balance in cells; together with the sodium ion, it creates a potential difference on both sides of the cell membranes involved in biosynthesis of protein, glycogen. The article also discusses the use of oral rehydration solutions in the recommendations of the World Health Organization (WHO). According to the WHO guidelines, oral fluid administration should be always preferred in the treatment of dehydration. According to the WHO data, when using oral rehydration solutions with balanced composition, the need for intravenous therapy is reduced by 33 %. Advantages of oral rehydration therapy are determined.


oral rehydration therapy; water-electrolyte ba­lance; Enhanced Recovery after Surgery


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