Treatment of cholera

The treatment of cholera is aimed primarily at compensating for body weight deficiency, correction of the continuing loss of water and electrolytes with stool, vomiting and exhaled air. Rehydration therapy is based on the same principles as in the treatment of other intestinal infections with dehydration.

For oral rehydration glucose-saline solutions (rehydron, "pediatric healer", glucosolan) are also used, and for parenteral - quartz and trisol, isotonic solution of 1.5% reamberin solution. Solutions for oral use are prepared before use, and intravenous preparations are heated to 37-38 ° C. The volume of liquid for oral rehydration (in case of I-II degree exsicosis) is calculated by the conventional method. It is very important to organize an accurate record of all losses of water and electrolytes, which is achieved by collecting feces and vomit, and by weighing the child every 4 hours.

In case of ineffectiveness or impossibility of oral rehydration (severe forms of dehydration with signs of hypovolemic shock, prolonged oliguria and anuria with indomitable vomiting, impaired absorption of glucose in the digestive tract), intravenous drip fluid (quartrel or trisol solutions) is indicated.

• To children of early age in the first hour of rehydration it is necessary to make up at least 40-50% of the initial deficiency of the fluid, which is less than 1-1.5 liters when excising the third degree. Further rehydration is carried out more slowly, at a rate of 10-20 ml / kg for 7-8 hours.
• Children 3-4 years of life rehydration can be carried out more intensively, the infusion rate in the first hour can reach 80 ml / kg. At the end of the first stage of rehydration, the child is re-weighed and, if rehydration is performed correctly, the body weight reaches the original, but should not exceed more than 10%.

The total daily volume of fluid for rehydration therapy (including intravenous) is calculated (as in other acute intestinal infections) according to tables or formulas. In children of early age, the relative density of plasma can not be used to calculate the required amount of fluid due to the large extracellular volume of the fluid.

Forecast

With timely diagnosis and early-initiated adequate rehydration therapy, the prognosis with cholera is favorable in most cases - the condition improves and recovery is very fast. In severe forms of cholera and decompensated dehydration, especially in young children and newborns, despite timely and adequate therapy, death may occur already in the initial period of the disease. The cause of death can be a layering of secondary bacterial infection (most often pneumonia).