[Oral rehydration therapy in acute diarrheal syndrome. A critical analysis of various aspects]

The use of the "universal" glucoelectrolytic solution proposed by the World Health Organization (WHO) for the treatment of the acute diarrheal syndrome, has now been recognized worldwide and successfully employed in the treatment of diarrhea and the maintenance of the normohydrated state once the patient has recuperated. All in all, it is necessary to comment and distinguish its beneficial aspects once placed into practice. This article primarily focuses on: 1. The recognition that local health indicators will determine importantly, the evaluation of the results obtained from the use of oral rehydration therapy; 2. The establishment of sound elements of judgement for the evaluation of the rehydrating solution from its composition to the volume employed; 3. Comment on the contraindications of oral rehydration therapy and describe the treatment plan suggested by the WHO; 4. Explain why in some parts of the world a sodium concentration of 60 is preferred over the 90 mmol/L found in the rehydrating solution; 5. Point out the risk of producing hypernatremia in patients rehydrated with the WHO solution and mechanisms which tend to reduce it; and finally, establish individualized management of water and electrolytic disturbances for certain regions of the world according to their health characteristics. Acute diarrhea; oral rehydration; critique.