Harris Lisa, Braun Michael
Madigan Army Medical Center Family Medicine Residency, 9040 Jackson Ave, Tacoma, WA 98431
FP Essent. 2017 Aug;459:35-38.
Oral electrolyte solutions are used widely for rehydration in diarrheal illness and to maintain hydration during vigorous exercise. In diarrheal illness, an oral rehydration solution (ORS) typically is preferred over intravenous fluids except for patients with severe dehydration. The preferred ORS is one similar to the glucose-containing reduced osmolarity World Health Organization ORS. There also are polymer-based solutions that use rice or wheat as the source of carbohydrates but these are not widely recommended. Use of other liquids, such as sport drinks, juice, soft drinks, and chicken broth is not recommended, though these can be considered for patients with no or mild dehydration. For maintaining hydration during exercise, particularly vigorous high-intensity exercise, recommendations are to consume fluids (ie, 5 to 7 mL/kg) and a sodium-containing snack at least 4 hours before. During exercise, individuals require 200 to 800 mL/hour of liquid that should contain 20 to 30 mEq/L of sodium. Carbohydrate intake is recommended during high-intensity exercise. Intake of excessive sodium-free fluids should be avoided to prevent exercise-induced hyponatremia. Additional fluids (ie, 1.5 L/kg of weight lost) can be consumed after exercise to restore hydration. Vitamin and mineral supplements are not recommended routinely for athletes unless known deficiencies exist.
口服电解质溶液广泛用于腹泻疾病的补液以及在剧烈运动期间维持水合状态。在腹泻疾病中,除了严重脱水的患者外,口服补液溶液(ORS)通常比静脉输液更受青睐。首选的ORS是一种类似于含葡萄糖的低渗性世界卫生组织ORS的溶液。也有以大米或小麦为碳水化合物来源的基于聚合物的溶液,但这些溶液并未得到广泛推荐。不建议使用其他液体,如运动饮料、果汁、软饮料和鸡汤,不过对于无脱水或轻度脱水的患者可以考虑使用。为了在运动期间,特别是剧烈的高强度运动期间维持水合状态,建议在至少4小时前摄入液体(即5至7毫升/千克)和一份含钠零食。在运动期间,个体每小时需要200至800毫升的液体,其中应含有20至30毫当量/升的钠。建议在高强度运动期间摄入碳水化合物。应避免摄入过多无钠液体以防止运动性低钠血症。运动后可以摄入额外的液体(即每丢失1千克体重摄入1.5升)以恢复水合状态。除非已知存在缺乏情况,否则不建议常规为运动员补充维生素和矿物质。